DelRosso Lourdes M, Artinian Hovig, Mogavero Maria P, Bruni Oliviero, Witmans Manisha, Tablizo Mary Anne, Sobremonte-King Michelle, Ferri Raffaele
University of California San Francisco, 155 N. Fresno St, Fresno, CA 93701, USA.
Seattle Childrens Hospital, Seattle, WA 98105, USA.
Children (Basel). 2024 May 28;11(6):658. doi: 10.3390/children11060658.
Children born prematurely (<37 weeks' gestation) are at increased risk of perinatal complications, comorbidities, and iron deficiency. Iron deficiency is associated with restless legs syndrome and periodic limb movement disorder. In this study, we assessed the prevalence of restless sleep disorder (RSD) and elevated periodic limb movements during sleep (PLMS) in children born prematurely who underwent polysomnography.
A retrospective chart review of sleep studies was conducted in children aged 1-18 years (median age 4 years) with a history of premature birth. Children with genetic syndrome, airway surgery, or tracheostomy were excluded. Three groups were compared: children with PLMS index >5, children with RSD, and children with neither elevated PLMS index nor RSD.
During the study, 2577 sleep studies were reviewed. Ninety-two studies fit our criteria and were included in the analysis. The median age at birth was 31 weeks, and the interquartile range (IQR) was 27-34 weeks. A total of 32 (34.8%) children were referred for restless sleep and 55 (59.8%) for snoring. After polysomnography, 18% were found to have a PLMS index >5/h, and 14% fit the criteria for restless sleep disorder (RSD). There were no statistically significant differences in PSG parameters among the children with RSD, PLMS, and the remaining group, except for lower obstructive apnea/hypopnea index (Kruskal-Wallis ANOVA 8.621, = 0.0135) in the RSD group (median 0.7, IQR 0.3-0.9) than in the PLMS (median 1.7, IQR 0.7-3.5) or the non-RSD/non-PLMS (median 2.0, IQR 0.8-4.5) groups.
There was an elevated frequency of RSD and elevated PLMS in our cohort of children born prematurely. Children born prematurely are at higher risk of iron deficiency which can be a contributor factor to sleep -related movement disorders. These results add new knowledge regarding the prevalence of RSD and PLMS in these children.
早产（妊娠<37周）出生的儿童发生围产期并发症、合并症和缺铁的风险增加。缺铁与不安腿综合征和周期性肢体运动障碍有关。在本研究中，我们评估了接受多导睡眠图检查的早产儿童中不安睡眠障碍（RSD）的患病率和睡眠期间周期性肢体运动（PLMS）增加的情况。
对1至18岁（中位年龄4岁）有早产史的儿童进行睡眠研究的回顾性图表审查。排除患有遗传综合征、气道手术或气管造口术的儿童。比较了三组：PLMS指数>5的儿童、患有RSD的儿童以及PLMS指数未升高且无RSD的儿童。
在研究期间，共审查了2577项睡眠研究。92项研究符合我们的标准并纳入分析。出生时的中位年龄为31周，四分位间距（IQR）为27 - 34周。共有32名（34.8%）儿童因不安睡眠被转诊，55名（59.8%）因打鼾被转诊。多导睡眠图检查后，发现18%的儿童PLMS指数>5次/小时，14%符合不安睡眠障碍（RSD）标准。RSD组、PLMS组和其余组之间的多导睡眠图参数无统计学显著差异，但RSD组（中位值0.7，IQR 0.3 - 0.9）的阻塞性呼吸暂停/低通气指数低于PLMS组（中位值1.7，IQR 0.7 - 3.5）和非RSD/非PLMS组（中位值2.0，IQR 0.8 - 4.5）（Kruskal - Wallis方差分析8.621，P = 0.0135）。
在我们的早产儿童队列中，RSD的发生率和PLMS增加。早产儿童缺铁风险较高，这可能是与睡眠相关运动障碍的一个促成因素。这些结果增加了关于这些儿童中RSD和PLMS患病率的新知识。
