城市少数民族儿童的睡眠、肥胖和哮喘之间的关联。
Associations between sleep, obesity, and asthma in urban minority children.
机构信息
Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York.
Department of Pediatrics, UC Davis Medical Center, Sacramento, California.
出版信息
J Clin Sleep Med. 2022 Oct 1;18(10):2377-2385. doi: 10.5664/jcsm.10114.
STUDY OBJECTIVES
Although obesity, asthma, and sleep-disordered breathing are interrelated, there is limited understanding of the independent contributions of body-mass index and pulmonary function on polysomnography in children with asthma.
METHODS
We conducted a retrospective chart review on 448 7- to 18-year-old children with asthma who had undergone polysomnography testing between 1/2007-12/2011 to elucidate the association between spirometry variables, body-mass index, and polysomnography parameters, adjusting for asthma and antiallergic medications.
RESULTS
Obese children had poorer sleep architecture and more severe gas exchange abnormalities compared to healthy weight children. Multivariate analysis revealed an independent association of body-mass index with sleep efficiency, with more light and less deep sleep in both obese and healthy-weight children, and with baseline oxygen saturation and oxygen nadir in obese children. In obese children, forced vital capacity was independently associated with less deep sleep (time in N3 sleep) as well as with oxygen nadir, while among healthy-weight children, forced expiratory volume directly correlated but forced vital capacity inversely correlated with deep sleep. In obese children, inhaled corticosteroid was associated with baseline oxygen saturation, and montelukast was associated with lower end-tidal carbon dioxide. In healthy-weight children, inhaled corticosteroid was associated with arousal awakening index, and montelukast was associated with light sleep. Antiallergic medications were not independently associated with polysomnography parameters.
CONCLUSIONS
Pulmonary function, body-mass index, and asthma medications have independent and differing influences on sleep architecture and gas exchange polysomnography parameters in obese and healthy-weight children with asthma. Asthma medications are associated with improved gas exchange in obese children and improved sleep architecture in healthy-weight children with asthma.
CITATION
Conrad LA, Nandalike K, Rani S, Rastogi D. Associations between sleep, obesity, and asthma in urban minority children. . 2022;18(10):2377-2385.
研究目的
尽管肥胖、哮喘和睡眠呼吸障碍相关，但对于肥胖症患者和非肥胖症患者的睡眠结构和呼吸暂停低通气指数（AHI）是否存在差异，以及这些差异与肥胖症和阻塞性睡眠呼吸暂停（OSA）的严重程度相关，我们目前知之甚少。
方法
我们对 448 名 7 至 18 岁的哮喘患儿进行了回顾性图表分析，这些患儿在 2007 年 1 月至 2011 年 12 月期间接受了睡眠呼吸监测，以阐明肺功能变量、体重指数（BMI）和睡眠呼吸监测参数之间的关系，并对哮喘和抗过敏药物进行了调整。
结果
与健康体重的儿童相比，肥胖儿童的睡眠结构较差，气体交换异常更为严重。多变量分析显示，BMI 与睡眠效率独立相关，肥胖和健康体重儿童的浅睡眠和深睡眠均减少，肥胖儿童的基础血氧饱和度和血氧低谷也减少。在肥胖儿童中，用力肺活量（FVC）与深睡眠（N3 睡眠时间）以及血氧低谷独立相关，而在健康体重儿童中，用力呼气量（FEV1）与深睡眠直接相关，而 FVC 与深睡眠呈负相关。在肥胖儿童中，吸入性皮质类固醇与基础血氧饱和度相关，而孟鲁司特与终末潮气二氧化碳相关。在健康体重的儿童中，吸入性皮质类固醇与觉醒唤醒指数相关，而孟鲁司特与浅睡眠相关。抗过敏药物与睡眠呼吸监测参数无独立相关性。
结论
在肥胖和健康体重的哮喘儿童中，肺功能、BMI 和哮喘药物对睡眠结构和气体交换睡眠呼吸监测参数有独立且不同的影响。哮喘药物可改善肥胖儿童的气体交换，改善健康体重儿童的睡眠结构。
引文
Conrad LA，Nandalike K，Rani S，Rastogi D。城市少数族裔儿童的睡眠、肥胖和哮喘之间的关联。儿科呼吸杂志。2022；18（10）：2377-2385。
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