Borrelli Melissa, Corcione Adele, Cimbalo Chiara, Annunziata Anna, Basilicata Simona, Fiorentino Giuseppe, Santamaria Francesca
Department of Translational Medical Sciences, Paediatric Pulmonology, Federico II University, 80131 Naples, Italy.
Department of Intensive Cure, Unit of Respiratory Pathophysiology, Monaldi Hospital, 80131 Naples, Italy.
Children (Basel). 2023 Aug 1;10(8):1331. doi: 10.3390/children10081331.
Obstructive sleep-disordered breathing (SDB) has significant impacts on health, and therefore, a timely and accurate diagnosis is crucial for effective management and intervention. This narrative review provides an overview of the current approaches utilised in the diagnosis of SDB in children. Diagnostic methods for SDB in children involve a combination of clinical assessment, medical history evaluation, questionnaires, and objective measurements. Polysomnography (PSG) is the diagnostic gold standard. It records activity of brain and tibial and submental muscles, heart rhythm, eye movements, oximetry, oronasal airflow, abdominal and chest movements, body position. Despite its accuracy, it is a time-consuming and expensive tool. Respiratory polygraphy instead monitors cardiorespiratory function without simultaneously assessing sleep and wakefulness; it is more affordable than PSG, but few paediatric studies compare these techniques and there is optional recommendation in children. Nocturnal oximetry is a simple and accessible exam that has high predictive value only for children at high risk. The daytime nap PSG, despite the advantage of shorter duration and lower costs, is not accurate for predicting SDB. Few paediatric data support the use of home testing during sleep. Finally, laboratory biomarkers and radiological findings are potentially useful hallmarks of SDB, but further investigations are needed to standardise their use in clinical practice.
阻塞性睡眠呼吸障碍（SDB）对健康有重大影响，因此，及时准确的诊断对于有效管理和干预至关重要。本叙述性综述概述了目前用于儿童SDB诊断的方法。儿童SDB的诊断方法包括临床评估、病史评估、问卷调查和客观测量的综合运用。多导睡眠图（PSG）是诊断的金标准。它记录大脑、胫骨和颏下肌肉的活动、心律、眼动、血氧饱和度、口鼻气流、腹部和胸部运动以及身体姿势。尽管其准确性高，但它是一种耗时且昂贵的工具。呼吸多导仪则是在不同时评估睡眠和清醒状态的情况下监测心肺功能；它比PSG更经济实惠，但很少有儿科研究比较这些技术，并且在儿童中没有可选的推荐。夜间血氧饱和度测定是一项简单且可及的检查，仅对高危儿童具有较高的预测价值。白天小睡PSG尽管具有持续时间短和成本低的优点，但对SDB的预测并不准确。很少有儿科数据支持在睡眠期间使用家庭测试。最后，实验室生物标志物和影像学检查结果可能是SDB的有用标志，但需要进一步研究以规范它们在临床实践中的应用。
