儿童打鼾与睡眠呼吸障碍之间的关系。

Relationship between snoring and sleep disordered breathing in children.

作者信息

Taytard Jessica, Beydon Maxime, Le Thai Claire, Lacin Fatma, Beydon Nicole

机构信息

APHP.Sorbonne Université, Service de Pneumologie Pédiatrique, Hôpital Armand Trousseau, Paris, F75012, France; INSERM, UMRS1158, Neurophysiologie respiratoire Expérimentale et Clinique, Sorbonne Université, Paris, F75013, France.

Sorbonne Université, INSERM, Institut Pierre Louis D'Epidémiologie et de Santé Publique, Equipe PEPITES, AP-HP, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), F75013, Paris, France.

出版信息

Sleep Med. 2025 Sep;133:106636. doi: 10.1016/j.sleep.2025.106636. Epub 2025 Jun 10.

DOI:10.1016/j.sleep.2025.106636

PMID:40544783

Abstract

BACKGROUND

the link between snoring and Sleep Disordered Breathing (SDB) is obvious, but little is known about the relationship between the intensity of the former and the severity of the latter in children.

METHODS

retrospective study of polysomnography (PSG) including snoring recordings in children without co-morbidity, except for possible asthma or obesity, and tested for suspected Obstructive Sleep Apnea Syndrome (OSAS).

RESULTS

We retrieved 477 PSG recordings performed in children (177 (37.1 %) females) with a median age of 8.8 years. Indexes (median [Q1; Q3]) were 154 [26; 374]/h for snore (SI), 3.0 [1.4; 5.8]/h for Obstructive Apnea-Hypopnea (OAHI), 1.5 [0.5; 4.6]/h for oxygen desaturation (ODI) and 6.9 [4.8; 10.6]/h for arousal (ArI, n = 463). The SI was significantly correlated to OAHI, ODI or ArI (ρ = 0.45, 0.41 and 0.31, respectively, all P-values <10). A SI threshold of 172/h had 78 % specificity to detect the absence of OSAS, whereas a threshold of 267/h had 82 % sensitivity to detect severe OSAS. In multivariate analyses, age/ODI were negatively and BMI/OAHI were positively associated with SI (β = -13 (95 % CI: -19,-7.5; p < 0.001); -5.8 (95 % CI: -11, -0.25; p = 0.041); 28 (95 % CI: 15, 41; p < 0.001), and 16 (95 % CI: 9.7, 22; p < 0.001), respectively).

CONCLUSION

SI is related to SDB as high SI (>267/h) is in favor of severe OSAS, and low SI (≤172/h) is in favor of no OSAS. Including standardized snoring analyses in level III recordings could be an easy objective tool to characterize children's SDB phenotype.

摘要

背景

打鼾与睡眠呼吸紊乱（SDB）之间的联系很明显，但对于儿童中前者的强度与后者的严重程度之间的关系却知之甚少。

方法

对多导睡眠图（PSG）进行回顾性研究，该研究纳入了除可能患有哮喘或肥胖症外无合并症且接受过阻塞性睡眠呼吸暂停综合征（OSAS）疑似检测的儿童的打鼾记录。

结果

我们检索到477份儿童PSG记录（177名（37.1%）女性），中位年龄为8.8岁。各项指标（中位数[四分位数间距]）分别为：打鼾指数（SI）154[26；374]/小时、阻塞性呼吸暂停低通气指数（OAHI）3.0[1.4；5.8]/小时、氧饱和度下降指数（ODI）1.5[0.5；4.6]/小时以及觉醒指数（ArI，n = 463）6.9[4.8；10.6]/小时。SI与OAHI、ODI或ArI显著相关（相关系数ρ分别为0.45、0.41和0.31，所有P值均<0.01）。SI阈值为172/小时时，检测无OSAS的特异性为78%，而阈值为267/小时时，检测重度OSAS的灵敏度为82%。在多变量分析中，年龄/ODI与SI呈负相关，BMI/OAHI与SI呈正相关（β分别为-13（95%置信区间：-19，-7.5；p<0.001）；-5.8（95%置信区间：-11，-0.25；p = 0.041）；28（95%置信区间：15，41；p<0.001），以及16（95%置信区间：9.7，22；p<0.001））。