10 岁及以下儿童阻塞性睡眠呼吸暂停与行为性失眠的关联。

The association of obstructive sleep apnea and behavioral insomnia in children ages 10 and under.

机构信息

Faculty of Medicine, The Hebrew University, Jerusalem, Israel.

Department of Military Medicine and "Tzameret," Faculty of Medicine, Hebrew, The University of Jerusalem, and Medical Corps, Israel Defense Forces, Israel.

出版信息

J Clin Sleep Med. 2024 Feb 1;20(2):245-251. doi: 10.5664/jcsm.10834.

DOI:10.5664/jcsm.10834

PMID:37772702

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10835786/

Abstract

STUDY OBJECTIVES

Behavioral insomnia of childhood (BIC) and obstructive sleep apnea (OSA) are highly prevalent conditions affecting 10%-20% and 1%-5% of children, respectively. Studies in adults and adolescents have suggested that comorbid insomnia and OSA may have distinct clinical characteristics. The association between the two conditions in the pediatric population has not been thoroughly investigated. This study aimed to examine the association between BIC and OSA in young children.

METHODS

Children, 6 months to 10 years old, referred to a sleep specialist and polysomnography at the Hadassah Medical Center between 2018 and 2021 were included in this retrospective analysis. We excluded children with chromosomal and craniofacial abnormalities, posttonsillectomy, or neurological impairment. BIC diagnosis was extracted from the electronic health records in accordance with the , third edition criteria. OSA was diagnosed by polysomnography (apnea-hypopnea index > 2 events/h).

RESULTS

Of 312 children (age 4.42 ± 2.42 years), 126 (40.4%) were non-OSA non-BIC, 125 (40.1%) OSA non-BIC, 34 (10.9%) BIC non-OSA, and 27 (8.7%) comorbid insomnia and OSA. OSA and non-OSA children had a similar prevalence of BIC. Children in the comorbid insomnia and OSA group were significantly younger (2.22 ± 1.21 years). Younger age at polysomnography, premature birth, and increased periodic leg movements on polysomnography were independently associated with OSA in a multivariable analysis. Lower body mass index, regardless of OSA, was associated with BIC.

CONCLUSIONS

Current findings do not support an association between behavioral insomnia of childhood and obstructive sleep apnea in children. Healthcare providers should consider each of these sleep disorders in children presenting with sleep difficulties since each has distinct diagnostic and therapeutic options.

CITATION

Yelov L, Reiter J, Meira E Cruz M, Gileles-Hillel A. The association of obstructive sleep apnea and behavioral insomnia in children ages 10 and under. . 2024;20(2):245-251.

摘要

研究目的

儿童行为性失眠（BIC）和阻塞性睡眠呼吸暂停（OSA）是两种高发疾病，分别影响 10%-20%和 1%-5%的儿童。成人和青少年的研究表明，共患失眠和 OSA 可能具有不同的临床特征。但这两种疾病在儿科人群中的关联尚未得到充分研究。本研究旨在探讨婴幼儿 BIC 与 OSA 的关系。

方法

本回顾性分析纳入了 2018 年至 2021 年期间在哈达萨医疗中心就诊并接受睡眠专家和多导睡眠图检查的 6 个月至 10 岁儿童。我们排除了染色体和颅面异常、扁桃体切除术后或神经功能障碍的儿童。BIC 诊断是根据《精神障碍诊断与统计手册》第 5 版标准从电子病历中提取的。OSA 由多导睡眠图诊断（呼吸暂停低通气指数>2 次/小时）。

结果

在 312 名儿童（年龄 4.42±2.42 岁）中，126 名（40.4%）为非 OSA 非 BIC、125 名（40.1%）为 OSA 非 BIC、34 名（10.9%）为 BIC 非 OSA、27 名（8.7%）为共患失眠和 OSA。OSA 和非 OSA 儿童的 BIC 患病率相似。共患失眠和 OSA 组的儿童年龄明显较小（2.22±1.21 岁）。多变量分析显示，多导睡眠图检查时年龄较小、早产和多导睡眠图上周期性肢体运动增加与 OSA 独立相关。无论是否存在 OSA，较低的体重指数均与 BIC 相关。

结论

目前的研究结果不支持儿童行为性失眠与阻塞性睡眠呼吸暂停之间存在关联。对于出现睡眠困难的儿童，医疗保健提供者应考虑到这两种睡眠障碍，因为每种障碍都有独特的诊断和治疗选择。

参考文献

Yelov L, Reiter J, Meira E Cruz M, Gileles-Hillel A. The association of obstructive sleep apnea and behavioral insomnia in children ages 10 and under.. 2024;20(2):245-251.