Qin Han, Huang Guimin, Zong Xinnan, Li Xiaodan, Kong Yaru, Jia Xinbei, Liao Zijun, Tai Jun
Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, China.
Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing, 100020, China.
Int J Pediatr Otorhinolaryngol. 2022 Nov;162:111285. doi: 10.1016/j.ijporl.2022.111285. Epub 2022 Aug 19.
This systematic review aims to assess the night-to-night variability (NtNV) in respiratory sleep parameters in children and the accuracy of diagnosing obstructive sleep apnea (OSA) in children based on a single-night sleep study.
The PubMed, EMBASE, and Cochrane Library databases were searched until March 8, 2021. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42021239838).
Our study included 395 patients from 5 articles. The mean (SD) age of all included patients was 11.78 (4.05) years. AHI was reported for 325 participants in 4 studies, and the mean change between two consecutive nights was -0.13 [95% CI: -0.40, 0.14] events per hour. The mean change in OAI was -0.07 [95% CI: -0.27, 0.12] events per hour in 187 participants across 3 studies. Based on the diagnostic criteria used, three studies reported that the diagnostic rates of OSA patients in a single-night sleep study were 83%, 84.6%, and 91%. The NtNV in AHI in children with severe and moderate OSA was greater than that in children with mild OSA (3.35 [95% CI: 0.07, 6.62] events per hour vs -0.15 [95% CI: -0.42, 0.12] events per hour), and these children with more severe OSA may have shown a higher AHI on the first night.
The NtNV in AHI was not statistically significant in the group sample of children. However, there were significant differences in NtNV in AHI between children with mild and moderate-to-severe OSA. Individual NtNV in respiratory sleep parameters may cause children to be misdiagnosed by single-night diagnostic sleep studies.
本系统评价旨在评估儿童呼吸睡眠参数的夜间变异性（NtNV），以及基于单夜睡眠研究诊断儿童阻塞性睡眠呼吸暂停（OSA）的准确性。
检索PubMed、EMBASE和Cochrane图书馆数据库至2021年3月8日。本研究已在国际系统评价前瞻性注册库（PROSPERO）数据库中注册（CRD42021239838）。
我们的研究纳入了5篇文章中的395例患者。所有纳入患者的平均（标准差）年龄为11.78（4.05）岁。4项研究中325名参与者报告了每小时呼吸暂停低通气指数（AHI），连续两晚的平均变化为每小时-0.13[95%置信区间：-0.40，0.14]次事件。3项研究中187名参与者的每小时阻塞性呼吸事件指数（OAI）平均变化为-0.07[95%置信区间：-0.27，0.12]次事件。根据所使用的诊断标准，3项研究报告单夜睡眠研究中OSA患者的诊断率分别为83%、84.6%和91%。中重度OSA儿童的AHI夜间变异性大于轻度OSA儿童（每小时3.35[95%置信区间：0.07，6.62]次事件 vs 每小时-0.15[95%置信区间：-0.42，0.12]次事件），这些中重度OSA儿童在第一晚的AHI可能更高。
在儿童组样本中，AHI的夜间变异性无统计学意义。然而，轻度与中重度OSA儿童的AHI夜间变异性存在显著差异。呼吸睡眠参数的个体夜间变异性可能导致儿童在单夜诊断性睡眠研究中被误诊。
