Prevalence and Risk Factors of Excessive Daytime Sleepiness in a Community Sample of Young Children: The Role of Obesity, Asthma, Anxiety/Depression, and Sleep
Prevalence and Risk Factors of Excessive Daytime Sleepiness in a Community Sample of Young Children: The Role of Obesity, Asthma, Anxiety/Depression, and Sleep
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DOI：
10.1093/sleep/34.4.503
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发表时间：
2011-04-01
期刊：
影响因子：
5.6
通讯作者：
Bixler, Edward O.
中科院分区：
文献类型：
--
作者：
Calhoun, Susan L.;Vgontzas, Alexandros N.;Bixler, Edward O.
研究目的：我们在一个大型的儿童普通人群样本中，调查了白天过度嗜睡（EDS）的患病率以及它与多种因素（例如，疾病主诉、肥胖、客观睡眠[包括睡眠呼吸障碍]，以及家长报告的焦虑/抑郁和睡眠困难）的关联。很少有研究对幼儿白天过度嗜睡的患病率和预测因素进行研究，在儿童普通人群样本中更是没有，而且研究结果不一致。
设计：横断面研究
环境：基于人群
参与者：来自普通人群的508名学龄儿童
干预措施：无
测量与结果：儿童接受了9小时的多导睡眠图（PSG）检查、体格检查，家长完成了健康、睡眠和心理调查问卷。儿童被分为两组：有家长报告白天过度嗜睡的和没有的。主观白天过度嗜睡的患病率约为15%。在有白天过度嗜睡的儿童与体重指数百分位、腰围、烧心、哮喘以及家长报告的焦虑/抑郁和睡眠困难之间发现了显著的单变量关系。白天过度嗜睡最强的预测因素是腰围、哮喘以及家长报告的焦虑/抑郁和入睡困难症状。所有多导睡眠图睡眠变量，包括呼吸暂停/低通气指数、咖啡因摄入和过敏，与白天过度嗜睡均无显著关联。
结论：白天过度嗜睡的出现似乎与肥胖、哮喘、家长报告的焦虑/抑郁和入睡困难的关联比与睡眠呼吸障碍（SDB）或客观睡眠中断本身更强。我们的研究结果表明，对于有白天过度嗜睡的儿童，应全面评估其焦虑/抑郁、夜间睡眠困难、哮喘、肥胖和其他代谢因素，而客观睡眠检查结果可能在临床上没有那么有用。
Study Objectives: We investigated the prevalence and association of excessive daytime sleepiness (EDS) with a wide range of factors (e. g., medical complaints, obesity, objective sleep [including sleep disordered breathing], and parent-reported anxiety/depression and sleep difficulties) in a large general population sample of children. Few studies have researched the prevalence and predictors of EDS in young children, none in a general population sample of children, and the results are inconsistent.Design: Cross-sectionalSetting: Population -based.Participants: 508 school-aged children from the general population.Interventions: N/AMeasurements and Results: Children underwent a 9-hour polysomnogram (PSG), physical exam, and parent completed health, sleep and psychological questionnaires. Children were divided into 2 groups: those with and without parent reported EDS. The prevalence of subjective EDS was approximately 15%. Significant univariate relationships were found between children with EDS and BMI percentile, waist circumference, heartburn, asthma, and parent reported anxiety/depression, and sleep difficulties. The strongest predictors of EDS were waist circumference, asthma, and parent-reported symptoms of anxiety/depression and trouble falling asleep. All PSG sleep variables including apnea/hypopnea index, caffeine consumption, and allergies were not significantly related to EDS.Conclusions: It appears that the presence of EDS is more strongly associated with obesity, asthma, parent reported anxiety/depression, and trouble falling asleep than with sleep disordered breathing (SDB) or objective sleep disruption per se. Our findings suggest that children with EDS should be thoroughly assessed for anxiety/depression, nocturnal sleep difficulties, asthma, obesity, and other metabolic factors, whereas objective sleep findings may not be as clinically useful.