Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.
BMC Pediatr. 2024 Jan 20;24(1):70. doi: 10.1186/s12887-023-04511-2.
Sleep disordered breathing (SDB) is broadly recognized to be associated with neurobehavioral deficits, which have significant impacts on developing-aged children and adolescents. Therefore, our study aimed to quantify the proportion of neurobehavioral impairments attributed to SDB in general children and adolescents by population attributable fraction (PAF).
The study was registered at PROSPERO (ID: CRD42023388143). We collected two types of literature on the prevalence of SDB and the risk of SDB-related neurobehavioral deficits from ten electronic databases and registers, respectively. The pooled effect sizes (P, P, RR) by random-effects meta-analysis were separately substituted into Levin's formula and Miettinen's formula to calculate PAFs.
Three prevalence literature and 2 risk literature, all with moderate/high quality, were included in the quantitative analysis individually. The prevalence of SDB was 11% (95%CI 2%-20%) in children and adolescents (P), while the SDB prevalence was 25% (95%CI 7%-42%) in neurobehavioral patients (P). SDB diagnosis at baseline was probably associated with about threefold subsequent incidence of neurobehavioral deficits (pooled RR 3.24, 95%CI 1.25-8.41), after multi-adjustment for key confounders. Up to 19.8% or 17.3% of neurobehavioral consequences may be attributed to SDB from Levin's formula and Miettinen's formula, respectively.
A certain number of neurobehavioral consequences may be attributable to SDB. It is essential for clinicians to identify and treat SDB timely, as well as screen for SDB in patients with neurobehavioral impairments. More longitudinal studies of SDB and neurobehavioral deficits are needed in the future to further certify the association between them.
睡眠呼吸障碍（SDB）被广泛认为与神经行为缺陷有关，这些缺陷对发育中的儿童和青少年有重大影响。因此，我们的研究旨在通过人群归因分数（PAF）来量化 SDB 对一般儿童和青少年的神经行为损害的比例。
该研究已在 PROSPERO（ID：CRD42023388143）上注册。我们分别从十个电子数据库和登记处收集了关于 SDB 患病率和 SDB 相关神经行为缺陷风险的两种文献。通过随机效应荟萃分析得出的合并效应大小（P、P、RR）分别代入 Levin 公式和 Miettinen 公式计算 PAFs。
三项患病率文献和两项风险文献，均具有中/高质量，分别单独纳入定量分析。儿童和青少年的 SDB 患病率为 11%（95%CI 2%-20%）（P），而神经行为障碍患者的 SDB 患病率为 25%（95%CI 7%-42%）（P）。在多因素调整关键混杂因素后，基线时的 SDB 诊断可能与后续发生神经行为缺陷的风险增加约三倍相关（合并 RR 3.24，95%CI 1.25-8.41）。根据 Levin 公式和 Miettinen 公式，SDB 可能导致 19.8%或 17.3%的神经行为后果。
一定数量的神经行为后果可能归因于 SDB。临床医生识别和及时治疗 SDB 以及对神经行为障碍患者筛查 SDB 非常重要。未来需要更多关于 SDB 和神经行为缺陷的纵向研究来进一步证实它们之间的关联。
