Polysomnographic characteristics in normal preschool and early school-aged children
Polysomnographic characteristics in normal preschool and early school-aged children
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DOI：
10.1542/peds.2005-1067
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发表时间：
2006-03-01
期刊：
影响因子：
8
通讯作者：
Gozal, D
中科院分区：
文献类型：
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作者：
Montgomery-Downs, HE;O'Brien, LM;Gozal, D
OBJECTIVE.本研究的目的是描述3至7岁正常儿童的夜间多导睡眠图测量。我们对路易斯维尔大学科赛尔儿童医院睡眠医学研究中心的2项关于学龄前儿童和学龄前儿童睡眠呼吸障碍的大型社区研究的参与者的正常多导睡眠图评估进行了回顾性分析。参与者包括542名年龄从3.2岁到8.6岁不等的健康儿童。结果。如果受试者在多导睡眠图中记录到打鼾，阻塞性呼吸暂停低通气指数>= 1.0，或周期性腿部运动指数>= 5.0，则被排除在分析之外。由于多导睡眠图的最大差异发生在5岁和6岁之间，因此对3岁至5岁的儿童和>= 6岁的儿童进行了分析。睡眠周期在不同年龄组之间是不同的，两者都显示出最初短暂的快速眼动期，在整个晚上延长，但只有老年组显示出整个晚上周期长度的减少。3 ~ 5岁儿童的平均阻塞性呼吸暂停指数为每小时总睡眠时间（TST）0.03，≥ 6岁儿童的平均TST为每小时0.05，而中枢性呼吸暂停指数分别为每小时TST 0.82和0.45。年龄较大的儿童仰卧睡眠时间的比例更大，呼吸暂停低通气指数根据身体位置而不同。20%的受试者潮气末二氧化碳值> 45 mm Hg，2.2%的受试者在>= 50% TST期间记录的值> 50 mm Hg。所有测量值均存在高方差。在3至7岁的正常儿童中，特别是在从学龄前到学龄早期的过渡期间，多导睡眠图测量发生了发育变化。我们在大量健康社区儿童中的发现包括迄今为止最广泛的基于实验室的儿科多导睡眠描记术的规范参考值汇编。
OBJECTIVE. The objective of this study was to describe overnight polysomnographic measures in normal children aged 3 to 7 years. We conducted a retrospective analysis of normal polysomnographic evaluations from participants in 2 large community-based studies of sleep-disordered breathing among preschoolers and early school-aged children at Kosair Children's Hospital Sleep Medicine Research Center at the University of Louisville. Participants included 542 healthy children with ages ranging from 3.2 to 8.6 years.RESULTS. Subjects were excluded from analysis if they had documented snoring during polysomnography, an obstructive apnea-hypopnea index of >= 1.0, or a periodic leg-movement index of >= 5.0. Because the greatest differences in polysomnography occurred between ages 5 and 6 years, analyses were performed for children 3 to 5 years and for ages >= 6. Sleep cyclicity was distinct between age groups, with both showing an initial brief rapid-eye-movement period, which lengthened across the night, but only the older group showing a decrease in cycle length across the night. Average obstructive apnea indices were 0.03 per hour of total sleep time (TST) for 3- to 5-year-old children and 0.05 per hour of TST for >= 6-year-old children, whereas central apnea indices were 0.82 and 0.45 per hour of TST, respectively. Older children spent a greater percentage of sleep time supine, and the apnea-hypopnea index differed according to body position. Twenty percent of all subjects had end tidal carbon dioxide values of > 45 mm Hg, and 2.2% had recorded values > 50 mm Hg during >= 50% TST. High variance was present on all measures.CONCLUSIONS. Developmental changes occur in several polysomnographic measures among normal children from 3 to 7 years of age, particularly during transition from preschool to early school age. Our findings in a large number of healthy community children comprise the most extensive compilation of normative reference values for laboratory-based pediatric polysomnography to date.