Department of Pediatrics, University of Louisville and Norton Children Medical Group, 9880 Angies Way Suite 300, Louisville, Kentucky, KY 40241, USA.
Department of Medicine, Division of Pulmonary Critical Care and Sleep Medicine, University of Louisville School Medicine, Louisville, Kentucky, USA.
Sleep Breath. 2024 Nov 22;29(1):1. doi: 10.1007/s11325-024-03179-x.
To assess OSA prevalence, comorbidities, and the influence of sleep stages and body positions on respiratory events distribution in toddlers aged 12-24 months.
A single center retrospective study that included toddlers aged 12-24 months old who underwent overnight PSG. OSA severity was categorized by obstructive apnea-hypopnea index (OAHI) as mild (1-4.9 events/h), moderate (5-9.9 events/h), and severe (≥ 10 events/h).
283 PSG data were included with a median age of 18 months (IQR 16-20.25) for the OSA group (168/283) and 19 months (IQR 16-22) for the non-OSA group (115/283) (p = 0.047). OSA prevalence was 68.5% (42.3% mild, 18.5% moderate, and 39% severe). 38.1% of children had no comorbidities, 24.4% had a history of prematurity and 11.3% had Down syndrome. Multivariate binominal regression analysis showed that children with history of prematurity (p = 0.017) and Down syndrome (p = 0.043) had higher odds of having OSA. The mean SaO in REM sleep was lower, and the mean time spent with oxygen saturation below 90% was higher in children with neuromuscular disease compared to those with other comorbidities. In toddlers without comorbidities, the median REM OAHI was 29.8 events/h (IQR: 58.48), whereas the median non-REM OAHI was 4.1 events/h (IQR: 10.4 p < 0.001). Supine OAHI was 7.9 (IQR: 24.9), and off supine OAHI was 10.5 (IQR: 18.1, p = 0.407).
In toddlers aged 12-24 months, history of prematurity and Down syndrome were significantly associated with OSA. Obstructive respiratory events occurred predominantly in REM sleep, and no significant positional relations were noted.
评估 12-24 个月大的幼儿阻塞性睡眠呼吸暂停低通气综合征（OSA）的患病率、合并症，以及睡眠分期和体位对呼吸事件分布的影响。
这是一项单中心回顾性研究，纳入了 12-24 个月大的接受过夜多导睡眠图（PSG）检查的幼儿。OSA 严重程度通过阻塞性呼吸暂停低通气指数（OAHI）进行分类：轻度（1-4.9 次/小时）、中度（5-9.9 次/小时）和重度（≥10 次/小时）。
共纳入 283 例 PSG 数据，其中 OSA 组（168/283）年龄中位数为 18 个月（IQR 16-20.25），非 OSA 组（115/283）年龄中位数为 19 个月（IQR 16-22）（p=0.047）。OSA 患病率为 68.5%（42.3%为轻度，18.5%为中度，39%为重度）。38.1%的儿童无合并症，24.4%有早产儿病史，11.3%有唐氏综合征。多变量二项式回归分析显示，有早产儿病史（p=0.017）和唐氏综合征（p=0.043）的儿童患 OSA 的几率更高。与其他合并症相比，患有神经肌肉疾病的儿童 REM 睡眠时的平均 SaO2 更低，氧饱和度低于 90%的时间更长。在无合并症的幼儿中，REM 期 OAHI 的中位数为 29.8 次/小时（IQR：58.48），而非 REM 期 OAHI 的中位数为 4.1 次/小时（IQR：10.4，p<0.001）。仰卧位 OAHI 为 7.9（IQR：24.9），非仰卧位 OAHI 为 10.5（IQR：18.1，p=0.407）。
在 12-24 个月大的幼儿中，早产儿病史和唐氏综合征与 OSA 显著相关。阻塞性呼吸事件主要发生在 REM 睡眠期，且无明显的体位相关关系。
