Chawla Jasneek, Harris Margaret-Anne, Black Robert, Leclerc Marie-Josee, Burns Hannah, Waters Karen A, Bernard Anne, Lushington Kurt, Heussler Helen
Department of Respiratory & Sleep Medicine, The Queensland Children's Hospital, Level 5a, 501 Stanley Street, South Brisbane, Queensland, 4101, Australia.
The Mater Research Institute, The University of Queensland, Brisbane, Australia.
Sleep Breath. 2021 Sep;25(3):1625-1634. doi: 10.1007/s11325-020-02264-1. Epub 2021 Jan 7.
Sleep disordered breathing (SDB) in children is commonly described as a continuum from primary snoring (PS) to obstructive sleep apnea (OSA), based on apnea indices from polysomnography (PSG). This study evaluated the difference in neurocognitive and behavioral parameters, prior to treatment, in symptomatic pre-school children with PSG-diagnosed OSA and PS.
All children had positive Pediatric Sleep Questionnaire (PSQ) results and were deemed suitable for adenotonsillectomy by an ENT surgeon. Neurocognitive and behavioral data were analyzed in pre-school children at recruitment for the POSTA study (The Pre-School OSA Tonsillectomy Adenoidectomy Study). Data were compared between PS and OSA groups, with Obstructive Apnea-Hypopnea Index, OAHI < 1/h or 1-10/h, respectively.
Ninety-one children were enrolled, including 52 with OSA and 39 with PS. Distribution of IQ (using Brief Intellectual Ability, BIA) was slightly skewed towards higher values compared with the reference population. No significant differences were found in neurocognitive or behavioral parameters for children with OSA versus those with PS.
Neurocognitive and behavioral parameters were similar in pre-school children symptomatic for OSA, regardless of whether or not PSG diagnosed PS or OSA. Despite having identical symptoms, children with PS on PSG are often treated conservatively, whereas those with OSA on PSG are considered for adenotonsillectomy. This study demonstrates that, regardless of whether or not PS or OSA is diagnosed on PSG, symptoms, neurocognition, and behavior are identical in these groups. We conclude that symptoms and behavioral disturbances should be considered in addition to OAHI when determining the need for treatment.
Australian and New Zealand Clinical Trials registration number ACTRN12611000021976.
基于多导睡眠图（PSG）得出的呼吸暂停指数，儿童睡眠呼吸障碍（SDB）通常被描述为一个从原发性打鼾（PS）到阻塞性睡眠呼吸暂停（OSA）的连续过程。本研究评估了经PSG诊断为OSA和PS的有症状学龄前儿童在治疗前神经认知和行为参数的差异。
所有儿童的儿童睡眠问卷（PSQ）结果均为阳性，且耳鼻喉科医生认为适合进行腺样体扁桃体切除术。在POSTA研究（学龄前OSA扁桃体切除术腺样体切除术研究）招募的学龄前儿童中分析神经认知和行为数据。比较PS组和OSA组的数据，阻塞性呼吸暂停低通气指数（OAHI）分别<1次/小时或1 - 10次/小时。
共纳入91名儿童，其中52名患有OSA，39名患有PS。与参考人群相比，智商分布（使用简易智力能力，BIA）略向较高值倾斜。OSA儿童与PS儿童在神经认知或行为参数方面未发现显著差异。
有OSA症状的学龄前儿童，无论PSG诊断为PS还是OSA，其神经认知和行为参数相似。尽管症状相同，但PSG诊断为PS的儿童通常采用保守治疗，而PSG诊断为OSA的儿童则考虑进行腺样体扁桃体切除术。本研究表明，无论PSG是否诊断为PS或OSA，这些组中的症状、神经认知和行为都是相同的。我们得出结论，在确定治疗需求时，除了OAHI外，还应考虑症状和行为障碍。
澳大利亚和新西兰临床试验注册号ACTRN12611000021976。
