Epidemiology of pediatric obstructive sleep apnea.
Epidemiology of pediatric obstructive sleep apnea.
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DOI：
10.1513/pats.200708-135mg
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发表时间：
2008-02-15
期刊：
影响因子：
--
通讯作者：
Chervin, Ronald D
中科院分区：
文献类型：
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作者：
Lumeng, Julie C;Chervin, Ronald D
儿童阻塞性睡眠呼吸暂停（OSA）仅在过去几十年中才被广泛认为是儿童中显著发病的可能原因。儿童OSA的许多临床特征及其流行病学决定因素与成人OSA不同。我们系统地回顾了被认为是儿科睡眠呼吸障碍（SDB）连续体的一部分，从原发性打鼾到OSA的流行病学研究。我们强调了一些方法学上的挑战，包括广泛可变的方法收集问卷数据有关打鼾，习惯性打鼾的定义，标准推进到进一步的诊断测试，SDB或OSA的客观诊断标准。面对这些限制，估计的人群患病率如下：父母报告的“总是”打鼾，1.5%至6%;父母报告的睡眠中呼吸暂停事件，0.2%至4%;父母报告的问卷调查中不同症状的SDB，4%至11%;诊断研究中不同标准诊断的OSA，1%至4%。在荟萃分析中，父母报告的任何定义的打鼾的总体患病率为7.45%（95%置信区间，5.75-9.61）。现在有合理的优势证据表明，SDB在男孩中比女孩更常见，在比其他人更重的儿童中更常见，新出现的数据表明非裔美国人的患病率更高。现有的数据不太令人信服，无法证明不同年龄的流行率存在差异。最后，我们概述了具体的未来研究需要在儿科SDB的流行病学。
Pediatric obstructive sleep apnea (OSA) has become widely recognized only in the last few decades as a likely cause of significant morbidity among children. Many of the clinical characteristics of pediatric OSA, and the determinants of its epidemiology, differ from those of adult OSA. We systematically reviewed studies on the epidemiology of conditions considered part of a pediatric sleep-disordered breathing (SDB) continuum, ranging from primary snoring to OSA. We highlight a number of methodologic challenges, including widely variable methodologies for collection of questionnaire data about symptomatology, definitions of habitual snoring, criteria for advancing to further diagnostic testing, and objective diagnostic criteria for SDB or OSA. In the face of these limitations, estimated population prevalences are as follows: parent-reported "always" snoring, 1.5 to 6%; parent-reported apneic events during sleep, 0.2 to 4%; SDB by varying constellations of parent-reported symptoms on questionnaire, 4 to 11%; OSA diagnosed by varying criteria on diagnostic studies, 1 to 4%. Overall prevalence of parent-reported snoring by any definition in meta-analysis was 7.45% (95% confidence interval, 5.75-9.61). A reasonable preponderance of evidence now suggests that SDB is more common among boys than girls, and among children who are heavier than others, with emerging data to suggest a higher prevalence among African Americans. Less convincing data exist to prove differences in prevalence based on age. We conclude by outlining specific future research needs in the epidemiology of pediatric SDB.