Lithuanian University of Health Sciences, Medical Academy, Pediatric Department, Kaunas, Lithuania.
Lithuanian University of Health Sciences, Medical Academy, Pediatric Department, The Center of Pediatric Chronic Respiratory Diseases, Kaunas, Lithuania.
Respir Med. 2024 Nov-Dec;234:107855. doi: 10.1016/j.rmed.2024.107855. Epub 2024 Nov 5.
To analyze the differences of clinical and diagnostic features of sleep related breathing disorders (SRBDs) between children with PWS and obese children, considering obesity as a unifying risk factor for sleep apnea.
This retrospective cohort study included ≥2 years of age children who had obesity and genetically confirmed Prader-Willi syndrome (PWS) or were non-PWS obese children. Out of 267 children, 58 children met inclusion criteria. Clinical data and records of standard overnight polysomnography (PSG) were collected and compared between groups during the study.
Obstructive sleep apnea (OSA) was identified in 97.2 % non-PWS obese children and 72.7 % PWS children (p = 0.072). Central sleep apnea (CSA) events were more commonly found in children with PWS (p = 0.035, OR 4.35, CI 95 % 1.05-18.03) as well as sleep-related hypoventilation (p = 0.016, OR 4.66, CI 95 % 1.26-17.34). Sleep efficiency was higher in PWS patients (p = 0.038). Sleep fragmentation was significantly associated with higher AHI only in non-PWS obese children (p = 0.027). In the PWS group patients, a moderate correlation was found between BMI and age (p = 0.025, r = 0.559, CI 95 % 0.087-0.826) as well as AHI and age (p = 0.003, r = 0.686, CI 95 % 0.232-0.895).
Non-PWS obese children, similar to those with PWS, exhibit a high risk of SRBDs. Although CSA and sleep-related hypoventilation may occur more frequently in patients with PWS, OSA remains the predominant disorder. Both patient groups are advised to undergo PSG due to the significant risk of SRBDs, particularly during adolescence.
分析伴有肥胖的 Prader-Willi 综合征（PWS）儿童与单纯肥胖儿童睡眠相关呼吸障碍（SRBD）的临床和诊断特征差异，考虑肥胖是睡眠呼吸暂停的统一危险因素。
本回顾性队列研究纳入了年龄≥2 岁的肥胖儿童，这些儿童均经基因检测证实患有 PWS 或为非 PWS 肥胖儿童。在 267 名儿童中，有 58 名符合纳入标准。在研究期间，收集并比较了两组的临床数据和标准整夜多导睡眠图（PSG）记录。
非 PWS 肥胖儿童中，阻塞性睡眠呼吸暂停（OSA）的检出率为 97.2%，而 PWS 儿童中为 72.7%（p=0.072）。在 PWS 儿童中，更常发现中枢性睡眠呼吸暂停（CSA）事件（p=0.035，OR 4.35，95%CI 1.05-18.03）和睡眠相关低通气（p=0.016，OR 4.66，95%CI 1.26-17.34）。PWS 患者的睡眠效率更高（p=0.038）。仅在非 PWS 肥胖儿童中，睡眠片段化与较高的呼吸暂停低通气指数（AHI）显著相关（p=0.027）。在 PWS 组中，BMI 与年龄之间存在中度相关性（p=0.025，r=0.559，95%CI 0.087-0.826），AHI 与年龄之间也存在中度相关性（p=0.003，r=0.686，95%CI 0.232-0.895）。
非 PWS 肥胖儿童与 PWS 儿童一样，存在发生 SRBD 的高风险。尽管 CSA 和睡眠相关低通气在 PWS 患者中可能更为常见，但 OSA 仍是主要疾病。鉴于 SRBD 的显著风险，尤其是在青春期，建议两组患者均进行 PSG。
