Polysomnographic Markers in Children With Cystic Fibrosis Lung Disease
Polysomnographic Markers in Children With Cystic Fibrosis Lung Disease
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DOI：
10.1542/peds.2015-1747
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发表时间：
2015-11-01
期刊：
影响因子：
8
通讯作者：
Schneider, Hartmut
中科院分区：
文献类型：
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作者：
Paranjape, Shruti M.;McGinley, Brian M.;Schneider, Hartmut
背景和目的：囊性纤维化症(CF)的儿童经常报告睡眠不佳、白天嗜睡增加和疲劳。这项研究的目的是确定不同疾病严重程度的CF儿童的呼吸模式。本研究的总体假设是，与鼾症对照组相比，CF儿童在睡眠中表现出常规多导睡眠图(PSG)没有报道或识别的气体交换异常和呼吸负荷增加。方法：分析年龄和BMI匹配的CF儿童和健康对照组的呼吸模式和PSG上的气体交换。结果：与年龄和体重指数相匹配的鼾症对照组相比，CF组儿童的氧合蛋白饱和度较低(95%+/-1.6%vs98%+/-0.6%，P=0.005)，呼吸频率较高(19.5+/-4.9vs16.5+/-1.2次/分钟，P=0.03)，非快速眼动睡眠时吸气流速受限的比例较高(44.1%+/-24.7%vs 12.1%+/-13.5%，P=0.007)。呼吸紊乱指数与鼾症对照组比较差异无统计学意义(1.5+/-2.7vs0.6+/-0.6次/h，P=.11)。结论：与年龄和体重指数匹配的正常鼾症对照组相比，CF组儿童睡眠时气体交换异常，呼吸负荷增加。由于这些异常与体重和肺功能无关，睡眠状态可能是及早发现呼吸异常和可能的CF肺部疾病进展的机会。
BACKGROUND AND OBJECTIVES: Children with cystic fibrosis (CF) often report poor sleep, increased daytime sleepiness, and fatigue. The purpose of this study was to identify respiratory patterns over the spectrum of disease severity in children with CF. The overall hypothesis for the current study is that children with CF compared with snoring control subjects demonstrate gas exchange abnormalities and increased respiratory loads during sleep that are not reported or recognized by conventional polysomnography (PSG).METHODS: Analysis of breathing patterns and gas exchange on PSG was performed in children with CF and healthy controls matched by age and BMI. For all CF and control subjects, the indication for PSG was evaluation for obstructive sleep apnea based on a history of snoring.RESULTS: Children with CF, compared with age-and BMI-matched snoring controls, demonstrated lower oxyhemoglobin saturation (95% +/- 1.6% vs 98% +/- 0.6%, P = .005), higher respiratory rate (19.5 +/- 4.9 vs 16.5 +/- 1.2 breaths per minute, P = .03), and a higher proportion of inspiratory flow limitation (44.1% +/- 24.7% vs 12.1% +/- 13.5%, P = .007) during non-rapid eye movement sleep. The respiratory disturbance index did not differ between CF and snoring control groups (1.5 +/- 2.7 vs 0.6 +/- 0.6 events per hour, P = .11).CONCLUSIONS: Children with CF exhibited abnormalities in gas exchange and increased respiratory load during sleep compared with normal age-and BMI-matched snoring controls. Because these abnormalities were independent of weight and lung function, sleep state may serve as an opportunity for early detection of breathing abnormalities and possibly CF lung disease progression.