Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia.
J Sleep Res. 2024 Feb;33(1):e13970. doi: 10.1111/jsr.13970. Epub 2023 Jun 21.
Children with Down syndrome are at increased risk of obstructive sleep disordered breathing, which has deleterious effects on daytime functioning. We aimed to examine the effects of treatment of sleep disordered breathing on sleep quality and daytime functioning in children with Down syndrome, and hypothesised that these would be improved. Thirty-four children completed a baseline study and a follow-up 2 years later. Measures at both time points included 7 days of actigraphy and parents completed a number of questionnaires assessing sleep, behaviour, daytime functioning, and quality of life. All children had overnight polysomnography at baseline; 15 children (44%) were treated. At baseline the treated group had more severe sleep disordered breathing compared with the untreated group: obstructive apneoa-hypopnoea index 29.3 ± 38.2 events/h versus 3.3 ± 5.2 events/h (p < 0.01). Actigraphy showed no significant differences in total sleep time, sleep efficiency, sleep schedules from baseline to follow up in either group. The sleep disturbance (p < 0.01) and total problems (p < 0.05) scales on the OSA-18 and the sleep disordered breathing subscale on the Paediatric Sleep Problem Survey Instrument (p < 0.01) improved in the treated children. There were no changes in any measure in the untreated children. Treatment of sleep disordered breathing improves symptoms, sleep disturbance and quality of life in children with Down syndrome, but has no demonstrable impact on actigraphic sleep measures or daytime behaviour or function. In contrast, children who were not treated, despite having less severe disease at baseline, had increased sleep disruption and no change in quality of life.
唐氏综合征患儿患阻塞性睡眠呼吸障碍的风险增加，这对日间功能有不良影响。我们旨在研究治疗睡眠呼吸障碍对唐氏综合征患儿睡眠质量和日间功能的影响，并假设这些方面会得到改善。34 名儿童完成了基线研究和 2 年后的随访。两个时间点的测量都包括 7 天的活动记录仪和家长完成了多项问卷，评估睡眠、行为、日间功能和生活质量。所有儿童在基线时均进行了过夜多导睡眠图检查；15 名儿童（44%）接受了治疗。在基线时，治疗组的睡眠呼吸障碍比未治疗组更严重：阻塞性呼吸暂停低通气指数为 29.3±38.2 次/小时，而未治疗组为 3.3±5.2 次/小时（p<0.01）。活动记录仪显示，两组的总睡眠时间、睡眠效率、睡眠时间表均无显著差异。在治疗组，睡眠障碍（p<0.01）和总问题（p<0.05）量表在 OSA-18 上以及儿童睡眠问题调查工具（PSQI）的睡眠呼吸障碍子量表上的评分均得到改善。未治疗组的任何指标均无变化。治疗睡眠呼吸障碍可改善唐氏综合征患儿的症状、睡眠障碍和生活质量，但对活动记录仪睡眠测量或日间行为或功能无明显影响。相比之下，尽管基线时疾病较轻，但未接受治疗的儿童睡眠紊乱程度增加，生活质量无变化。
