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阻塞性睡眠呼吸暂停影响儿童的心理和行为发育:病例对照研究。

Obstructive sleep apnea affects the psychological and behavioural development of children-a case-control study.

机构信息

Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China.

Department of Otolaryngology, Chongqing Youyou Baobei Women and Children's Hospital, Chongqing, China.

出版信息

J Sleep Res. 2024 Feb;33(1):e13924. doi: 10.1111/jsr.13924. Epub 2023 May 16.

Abstract

This study aims to investigate the effects of obstructive sleep apnea on paediatric psychological and behavioural abnormalities. A total of 1086 paediatric patients with obstructive sleep apnea and 728 sample snoring controls were enrolled in the study. Patients with obstructive sleep apnea underwent bilateral tonsillectomy plus adenoidectomy or adenoidectomy alone. Repeated Autism Behaviour Checklist, Spence Children's Anxiety Scale, and Children's Depression Inventory were performed to assess the autism symptoms, anxiety level and depressive symptoms before and after surgery. The score of Autism Behaviour Checklist in preschool children with obstructive sleep apnea was higher than that in control. In school children with obstructive sleep apnea, the score of Spence Children's Anxiety Scale was also higher. School children with obstructive sleep apnea with depressive symptoms were significantly higher than that in control. The scores of Autism Behaviour Checklist, Spence Children's Anxiety Scale, and Children's Depression Inventory in the obstructive sleep apnea group after surgery were significantly lower than that before surgery. Our study showed that the score of Spence Children's Anxiety Scale and Children's Depression Inventory had a close correlation with the illness course and hypoxia duration. The Spence Children's Anxiety Scale and Children's Depression Inventory scores are also closely associated with the Autism Behaviour Checklist score. These results suggest that obstructive sleep apnea may have a significant impact on autism symptoms, anxiety levels and depressive symptoms in children. We found that the longer the duration of the obstructive sleep apnea course and hypoxia, the greater the impact on anxiety level and depressive symptoms. The suspected autism symptoms, anxiety level and depressive symptoms in children with obstructive sleep apnea were also significantly correlated. Thus, early detection and timely treatment may often reverse the psychological and behavioural abnormalities caused by obstructive sleep apnea.

摘要

本研究旨在探讨阻塞性睡眠呼吸暂停对儿科心理和行为异常的影响。共纳入 1086 例阻塞性睡眠呼吸暂停患儿和 728 例样本打鼾对照。阻塞性睡眠呼吸暂停患儿行双侧扁桃体切除术加腺样体切除术或单纯腺样体切除术。分别在手术前后采用孤独症行为检查表、斯宾塞儿童焦虑量表和儿童抑郁量表评估孤独症症状、焦虑水平和抑郁症状。阻塞性睡眠呼吸暂停学龄前儿童孤独症行为检查表评分高于对照组。阻塞性睡眠呼吸暂停学龄儿童斯宾塞儿童焦虑量表评分也较高。阻塞性睡眠呼吸暂停伴抑郁症状的学龄儿童明显高于对照组。阻塞性睡眠呼吸暂停组手术后孤独症行为检查表、斯宾塞儿童焦虑量表和儿童抑郁量表评分均明显低于术前。本研究表明,斯宾塞儿童焦虑量表和儿童抑郁量表评分与病程和缺氧时间密切相关。斯宾塞儿童焦虑量表和儿童抑郁量表评分也与孤独症行为检查表评分密切相关。这些结果表明阻塞性睡眠呼吸暂停可能对儿童的孤独症症状、焦虑水平和抑郁症状有显著影响。我们发现阻塞性睡眠呼吸暂停病程和缺氧时间越长,对焦虑水平和抑郁症状的影响越大。阻塞性睡眠呼吸暂停患儿的疑似孤独症症状、焦虑水平和抑郁症状也显著相关。因此,早期发现和及时治疗往往可以逆转阻塞性睡眠呼吸暂停引起的心理和行为异常。

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