Department of Pediatrics, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Department of Pediatric Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
J Clin Sleep Med. 2022 Sep 1;18(9):2143-2154. doi: 10.5664/jcsm.10062.
The main aim was to evaluate the prevalence of sleep-disordered breathing (SDB) in patients with Chiari II malformation (CM-II). The secondary objectives were to evaluate the association between SDB, morphological abnormalities, and neurological symptoms and to review the literature on patients with SDB and CM-II.
The study has a cross-sectional, case-control design. Patients with CM-II (patients) were compared to control patients referred for clinical polysomnography in the Sleep Medicine Unit, matched for age and sex. All patients underwent brain and spinal cord magnetic resonance imaging, and polysomnography was conducted for all participants. A review of the literature about SDB in patients with CM-II was performed.
Forty patients were included (20 patients vs 20 control patients). SDB was identified in 45% of patients, a significantly higher prevalence compared to control patients. Three patients presented with purely obstructive SDB, 3 patients with purely central SDB, and 3 patients with both obstructive and central SDB. Compared with control patients, patients with CM-II showed a higher oxygen desaturation index (median: CM-II, 3.7; interquartile range, 1.6-19.5; control patients: 1.1; interquartile range, 0.3-3.2) and obstructive apnea-hypopnea index (median: CM-II, 1.5; interquartile range, 0.5-5.1; control patients, 0.1; interquartile range, 0.0-0.7). A logistic regression showed that the risk of developing SDB in patients affected by CM-II was 14.7 times higher than in the control population.
Our study and literature review showed a high prevalence of SDB in patients with CM-II. These patients are often asymptomatic at diagnosis, suggesting that PSG should be routinely provided in this population.
Lazzareschi I, Curatola A, Massimi L, et al. Sleep-disordered breathing in patients with Chiari malformation type II: a case-control study and review of the literature. 2022;18(9):2143-2154.
本研究旨在评估 Chiari II 畸形（CM-II）患者中睡眠呼吸障碍（SDB）的患病率。次要目标是评估 SDB 与形态异常和神经症状之间的关系，并回顾 SDB 合并 CM-II 患者的文献。
本研究采用了横断面病例对照设计。CM-II 患者（患者）与睡眠医学科进行临床多导睡眠图检查的对照患者进行比较，年龄和性别相匹配。所有患者均行脑脊髓磁共振成像，所有参与者均行多导睡眠图检查。对 SDB 合并 CM-II 患者的文献进行了回顾。
共纳入 40 例患者（20 例患者与 20 例对照患者）。患者中 SDB 的发生率为 45%，明显高于对照患者。3 例患者表现为单纯阻塞性 SDB，3 例患者表现为单纯中枢性 SDB，3 例患者同时存在阻塞性和中枢性 SDB。与对照患者相比，CM-II 患者的氧减饱和度指数（中位数：CM-II，3.7；四分位距，1.6-19.5；对照患者：1.1；四分位距，0.3-3.2）和阻塞性呼吸暂停低通气指数（中位数：CM-II，1.5；四分位距，0.5-5.1；对照患者，0.1；四分位距，0.0-0.7）更高。逻辑回归显示，CM-II 患者发生 SDB 的风险是对照人群的 14.7 倍。
本研究和文献复习表明，CM-II 患者中 SDB 的患病率较高。这些患者在诊断时常常无症状，提示在该人群中应常规提供 PSG。
Lazzareschi I, Curatola A, Massimi L, et al. Sleep-disordered breathing in patients with Chiari malformation type II: a case-control study and review of the literature. 2022;18(9):2143-2154.
