Blumer Sigalit, Eli Ilana, Kaminsky-Kurtz Shani, Shreiber-Fridman Yarden, Dolev Eran, Emodi-Perlman Alona
Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel.
The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6139001, Israel.
J Clin Med. 2022 Sep 22;11(19):5570. doi: 10.3390/jcm11195570.
In recent years, we have witnessed a growing interest in pediatric sleep-related breathing disorders (SRBD). Although a Pediatric Sleep Questionnaire (PSQ) exists and was found reliable in screening SRBD in children, many of the children remain underdiagnosed. The aim of the present study was to define anamnestic and clinical findings that can serve as red flags indicating the presence of SRBD in children.
227 children aged 4-12 years old were evaluated with regard to the following parameters: (i) anamnestic variables (e.g., general state of health, oral habits, bruxism, esophageal reflux, sleep continuity, snoring); (ii) clinical parameters (e.g., oral mucosa, palate, tonsils, tongue, floor of the mouth, angle classification, gingival health, caries risk) and (iii) presence of SRBD (through the PSQ).
Significant differences between children with and without SRBD were observed regarding continuous sleep, developmental delay, mouth breathing, and snoring. Taking medications for ADHD increased the odds of SRBD in children by over seven times, non-continuous sleep increased the odds of SRBD by six times, mouth breathing increased the odds by almost five times, and snoring increased the odds by over three times.
Child caregivers from various fields (dentists, orthodontists, pediatric physicians, school nurses) should actively inquire about disturbed sleep, medications for ADHD, snoring, and mouth breathing among their young patients. Initial screening through a few simple questions may help raise red flags that can assist in the early detection of SRBD in children and lead to proper diagnosis and treatment.
近年来，我们注意到对儿童睡眠相关呼吸障碍（SRBD）的关注日益增加。尽管存在一份儿童睡眠问卷（PSQ），且发现其在筛查儿童SRBD方面可靠，但仍有许多儿童未得到诊断。本研究的目的是确定可作为警示信号以提示儿童存在SRBD的记忆性和临床发现。
对227名4至12岁儿童进行了以下参数的评估：（i）记忆性变量（例如，总体健康状况、口腔习惯、磨牙症、食管反流、睡眠连续性、打鼾）；（ii）临床参数（例如，口腔黏膜、腭、扁桃体、舌、口腔底部、角分类、牙龈健康、龋齿风险）以及（iii）SRBD的存在情况（通过PSQ）。
在持续睡眠、发育迟缓、口呼吸和打鼾方面，观察到患有和未患有SRBD的儿童之间存在显著差异。服用治疗注意力缺陷多动障碍（ADHD）的药物使儿童患SRBD的几率增加了七倍多，非持续睡眠使患SRBD的几率增加了六倍，口呼吸使几率增加了近五倍，打鼾使几率增加了三倍多。
来自各个领域的儿童护理人员（牙医、正畸医生、儿科医生、学校护士）应积极询问其年轻患者的睡眠障碍、治疗ADHD的药物、打鼾和口呼吸情况。通过几个简单问题进行初步筛查可能有助于提出警示信号，这有助于早期发现儿童SRBD并导致正确的诊断和治疗。
