Sleep and daytime behavior in children with obstructive sleep apnea and behavioral sleep disorders
Sleep and daytime behavior in children with obstructive sleep apnea and behavioral sleep disorders
复制标题
DOI：
10.1542/peds.102.5.1178
复制
发表时间：
1998-11-01
期刊：
影响因子：
8
通讯作者：
Spirito, A
中科院分区：
文献类型：
--
作者：
Owens, J;Opipari, L;Spirito, A
Objective.本研究的目的是：1）检查一组患有原发性医学睡眠障碍的儿童的睡前睡眠行为和与日间嗜睡相关的日间行为（阻塞性睡眠呼吸暂停综合征[OSAS]）与一组患有原发性行为睡眠障碍（BSD）的儿童相比，（限制设置睡眠障碍或睡眠发作关联障碍）;和2）调查共病BSD对OSAS. Methods的睡眠和日间行为后果的影响。在3年的时间里，将主要诊断为经多导睡眠图证实的OSAS（n = 100）或BSD（n = 52）的儿童转诊到儿科睡眠障碍诊所，比较几种父母报告措施，评估以下领域：睡眠呼吸障碍症状，其他睡眠行为（主要是异眠症），睡前行为和外部化日间行为问题。根据是否出现睡眠延迟和/或夜间觉醒时间延长，将OSAS患者分为单纯OSAS组（n = 78）和OSAS+行为睡眠诊断组（n = 22），比较两组患者的父母报告症状。几乎四分之一的OSAS组有临床显著的行为睡眠问题，主要是睡前阻力，除了OSAS。在BSD和OSAS-BSD组中，睡前抵抗与睡眠时间显著缩短相关。虽然OSAS-BSD组的病情较单纯OSAS组轻（多导睡眠图变量定义），但他们的父母认为他们有更多与日间睡眠相关的日间外化行为问题。这项研究的结果表明，评估共病BSD应在所有儿童表现为OSAS的症状。这些BSD的共存可能会导致睡眠剥夺，从而导致这些儿童白天嗜睡的行为表现。
Objective. The purpose of this study was: 1) to examine both bedtime sleep behaviors and daytime behaviors associated with daytime sleepiness in a group of children with a primary medical sleep disorder (obstructive sleep apnea syndrome [OSAS]) compared with a group of children with a primary behavioral sleep disorder (BSD) (limit setting sleep disorder or sleep onset association disorder); and 2) to investigate the impact of a comorbid BSD on sleep and daytime behavioral consequences of OSAS.Methods. Children referred to a pediatric sleep disorders clinic during a 3-year period with a primary diagnosis of either polysomnographically-confirmed OSAS (n = 100) or a BSD (n = 52) were compared on several parent report measures assessing the following domains: symptoms of sleep disordered breathing, other sleep behaviors (primarily parasomnias), bedtime behaviors, and externalizing daytime behavior problems. The OSAS sample was then divided into a pure OSAS group (n = 78) and an OSAS plus a behavioral sleep diagnosis group (n = 22) based on the presence or absence of delayed sleep onset and/or prolonged nightwakings and compared on the parent-report symptom domains.Results. Almost one-quarter of the OSAS group had clinically significant behavioral sleep problems, primarily bedtime resistance, in addition to OSAS. Bedtime resistance was associated with a significantly shortened sleep duration in both the BSD and OSAS-BSD groups. Although the OSAS-BSD group had less severe disease, as defined by polysomnographic variables, than the pure OSAS group, they were rated by their parents as having more daytime externalizing behavior problems associated with daytime sleepiness.Conclusions. The results of this study suggest that evaluation for comorbid BSD should be done in all children presenting with symptoms of OSAS. The coexistence of such BSDs may contribute significantly to sleep deprivation, and thus to behavioral manifestations of daytime sleepiness in these children.