Sleep pressure score: a new index of sleep disruption in snoring children
Sleep pressure score: a new index of sleep disruption in snoring children
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DOI：
10.1093/sleep/27.2.274
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发表时间：
2004-03-15
期刊：
影响因子：
5.6
通讯作者：
Gozal, D
中科院分区：
文献类型：
--
作者：
Tauman, R;O'Brien, LM;Gozal, D
研究目的：白天过度嗜睡（EDS），作为衡量的客观标准，是罕见的打鼾儿童，尽管EDS相关的行为表现的患病率很高。我们假设睡眠结构和觉醒指数可能会随着睡眠呼吸障碍（SDB）的严重程度而改变。设计：回顾性和前瞻性研究。设置：通过睡眠诊所或学校项目分发问卷;多导睡眠图在肯塔基州路易斯维尔的科赛尔儿童医院进行。参与者：为了研究这个问题，182名SDB儿童、163名原发性打鼾儿童和214名平均年龄为6.9 ± 2.6岁的对照儿童在实验室接受了多导睡眠图评估。测量和结果：SDB组的慢波睡眠（占总睡眠时间的百分比）显著增加，而快速眼动睡眠（占总睡眠时间的百分比）显著减少（P <0.0001）。自主和呼吸唤醒指数和呼吸暂停低通气指数（AHI）分别呈负相关和正相关，表明相互作用。基于这些观察结果，睡眠压力评分（SPS）作为睡眠稳态破坏的替代数字测量。SPS表现出相对于AHI的线性增加，在AHI为每小时总睡眠时间30至40时达到平台。此外，非裔美国人和肥胖儿童的SPS值显著较高（P < .0001）。结论：睡眠结构在SDB儿童中没有保留。提出了一种可以计算打鼾儿童的睡眠倾向和睡眠稳态失调的算法，该算法在嗜睡评估中可能具有实用价值。
Study Objectives: Excessive daytime sleepiness (EDS), as measured by objective criteria, is infrequent in snoring children despite a high prevalence of EDS-related behavioral manifestations. We hypothesized that sleep architecture and arousal indexes may be altered relative to the severity of sleep-disordered breathing (SDB).Design: Retrospective and prospective study.Setting: Questionnaires were distributed through sleep clinic or school program; polysomnograms were performed at Kosair Children's Hospital in Louisville, Kentucky.Participants: To examine this issue, 182 children with SDB, 163 children with primary snoring, and 214 control children with a mean age of 6.9 +/- 2.6 years underwent polysomnographic evaluation in the laboratory.Measurements and Results: Significant increases in slow-wave sleep (percentage of total sleep time) and decreases in rapid eye movement sleep (percentage of total sleep time) occurred in the SDB group (P < .0001). Spontaneous and respiratory arousal indexes and the apnea-hypopnea index (AHI) displayed negative and positive correlations, respectively, suggesting reciprocal interactions. Based on these observations, a sleep pressure score (SPS) was derived as a surrogate numeric measure for disrupted sleep homeostasis. The SPS exhibited linear increases relative to AHI, reaching a plateau at an AHI of 30 to 40 per hour of total sleep time. Furthermore, SPS values were significantly higher among African American and obese children (P < .0001).Conclusions: Sleep architecture is not preserved in children with SDB. An algorithm allowing for calculation of sleep propensity and disturbed sleep homeostasis in children who snore is proposed and may be of practical value in the assessment of sleepiness.