School of Medicine, Pontificia Universidad Javeriana, Bogota, Colombia.
Obstructive Sleep Apnea Interest Group, Bogota, Colombia.
High Alt Med Biol. 2019 Sep;20(3):231-235. doi: 10.1089/ham.2017.0149. Epub 2019 Jun 28.
The aim of the study was to assess the incidence of sleep-related breathing disorders (SRBD) in children with Down Syndrome (DS) living at high altitude. A retrospective descriptive study was conducted on 53 children with DS who underwent polysomnography (PSG) at San Ignacio University Hospital (2640 m/8660 ft above sea level) from 2009 to 2016. Data were extracted from official PSG reports and analyzed using measures of central tendency and dispersion, frequency calculation, ranges, and confidence intervals. Associations were examined using -test, chi-square test, and analysis of variance test. Obstructive sleep apnea (OSA) was present in 90.5% of children. Central sleep apnea was evident in 11.3%. Periodic breathing was seen in 15.1% of patients. Snoring was able to predict OSA with a sensitivity of 61.7%, a specificity of 100%, and negative predictive value of 25%. Children with DS who live at high altitude have a high incidence of SRBD. Our findings show a higher incidence of SRBD than previously reported in the population with DS. Furthermore, snoring was not sensitive enough to predict OSA. This high risk of SRBD may increase the risk of other comorbid conditions seen in the population with DS. Our results support the need for routine PSG screening independent of symptoms such as snoring status.
本研究旨在评估生活在高海拔地区的唐氏综合征（DS）儿童睡眠相关呼吸障碍（SRBD）的发生率。对 2009 年至 2016 年在圣伊西德罗大学医院（海拔 2640 米/8660 英尺）接受多导睡眠图（PSG）检查的 53 名 DS 儿童进行了回顾性描述性研究。从官方 PSG 报告中提取数据，并使用集中趋势和离散度、频率计算、范围和置信区间进行分析。使用 -检验、卡方检验和方差分析检验来检验关联。90.5%的儿童存在阻塞性睡眠呼吸暂停（OSA）。11.3%的儿童存在中枢性睡眠呼吸暂停。15.1%的患者存在周期性呼吸。打鼾对 OSA 具有 61.7%的灵敏度、100%的特异性和 25%的阴性预测值，能够预测 OSA。生活在高海拔地区的 DS 儿童 SRBD 的发生率较高。我们的研究结果显示，DS 人群的 SRBD 发生率高于以往报道。此外，打鼾对 OSA 的预测不够敏感。这种 SRBD 的高风险可能会增加 DS 人群中其他合并症的风险。我们的研究结果支持无论打鼾状态等症状如何，都需要进行常规 PSG 筛查。
