Pascoe John E, Zygmunt Alexander, Ehsan Zarmina, Gurbani Neepa
Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Semin Pediatr Neurol. 2023 Dec;48:101092. doi: 10.1016/j.spen.2023.101092. Epub 2023 Oct 12.
Sleep disordered breathing (SDB) is prevalent among children with neuromuscular disorders (NMD). The combination of respiratory muscle weakness, altered drive, and chest wall distortion due to scoliosis make sleep a stressful state in this population. Symptomatology can range from absent to snoring, nocturnal awakenings, morning headaches, and excessive daytime sleepiness. Sequelae of untreated SDB includes cardiovascular effects, metabolic derangements, and neurocognitive concerns which can be compounded by those innate to the NMD. The clinician should have a low threshold for obtaining polysomnography and recognize the nuances of individual disorders due to disproportionately impacted muscle groups such as hypoventilation in ambulating patients from diaphragm weakness. Non-invasive or invasive ventilation are the mainstay of treatment. In this review we explore the diagnosis and treatment of SDB in children with various NMD.
睡眠呼吸障碍（SDB）在患有神经肌肉疾病（NMD）的儿童中很常见。呼吸肌无力、驱动力改变以及脊柱侧弯导致的胸壁畸形，使得睡眠在这一人群中成为一种压力状态。症状表现从无到打鼾、夜间觉醒、晨起头痛以及日间过度嗜睡不等。未经治疗的SDB的后遗症包括心血管影响、代谢紊乱以及神经认知问题，而这些问题可能会因NMD本身固有的问题而更加复杂。临床医生对于进行多导睡眠图检查应保持较低的阈值，并认识到由于不同肌肉群受到不成比例的影响而导致的个体疾病的细微差别，例如因膈肌无力而导致行走患者出现通气不足。无创或有创通气是主要的治疗方法。在这篇综述中，我们探讨了患有各种NMD的儿童中SDB的诊断和治疗。
