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儿科阻塞性睡眠呼吸暂停的诊断趋势

Trends in Diagnosing Obstructive Sleep Apnea in Pediatrics.

作者信息

Kang Mandip, Mo Fan, Witmans Manisha, Santiago Vicente, Tablizo Mary Anne

机构信息

Department of Medicine, University of California San Francisco-Fresno, Fresno, CA 93701, USA.

Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada.

出版信息

Children (Basel). 2022 Feb 24;9(3):306. doi: 10.3390/children9030306.

Abstract

Obstructive sleep apnea in children has been linked with behavioral and neurocognitive problems, impaired growth, cardiovascular morbidity, and metabolic consequences. Diagnosing children at a young age can potentially prevent significant morbidity associated with OSA. Despite the importance of taking a comprehensive sleep history and performing thorough physical examination to screen for signs and symptoms of OSA, these findings alone are inadequate for definitively diagnosing OSA. In-laboratory polysomnography (PSG) remains the gold standard of diagnosing pediatric OSA. However, there are limitations related to the attended in-lab polysomnography, such as limited access to a sleep center, the specialized training involved in studying children, the laborious nature of the test and social/economic barriers, which can delay diagnosis and treatment. There has been increasing research about utilizing alternative methods of diagnosis of OSA in children including home sleep testing, especially with the emergence of wearable technology. In this article, we aim to look at the presentation, physical exam, screening questionnaires and current different modalities used to aid in the diagnosis of OSA in children.

摘要

儿童阻塞性睡眠呼吸暂停与行为和神经认知问题、生长发育受损、心血管疾病及代谢后果有关。在儿童年幼时进行诊断有可能预防与阻塞性睡眠呼吸暂停相关的严重疾病。尽管全面了解睡眠史并进行全面体格检查以筛查阻塞性睡眠呼吸暂停的体征和症状很重要,但仅凭这些发现不足以明确诊断阻塞性睡眠呼吸暂停。实验室多导睡眠图(PSG)仍然是诊断儿童阻塞性睡眠呼吸暂停的金标准。然而,实验室多导睡眠图检查存在一些局限性,例如睡眠中心的可及性有限、研究儿童所需的专业培训、检查过程繁琐以及社会/经济障碍,这些都可能延迟诊断和治疗。关于利用替代方法诊断儿童阻塞性睡眠呼吸暂停,尤其是随着可穿戴技术的出现进行家庭睡眠测试的研究越来越多。在本文中,我们旨在探讨儿童阻塞性睡眠呼吸暂停的临床表现、体格检查、筛查问卷以及目前用于辅助诊断的不同方式。

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