| ObjectiveThis study was designed to analyze sleep architecture and respiratory disturbances during sleep between preschool and prepubertal children with obstructive sleep apnea syndrome. We hope this study can help us to explore how OSAS affects children's sleep and to find the sleep and respiratory characteristics, and furthermore, to explain the causes that children with OSAS frequently suffer from behavioral problem and neurocognitive impairment.Subjects and methods1. Subjects(1) OSAS group: 60 children with OSAS were recruited in this study between March 2001 and Febarary 2004. All patients with OSAS presented chief complaints of snoring and difficult breathing at night. They were diagnosed on the criteria of standard pediatric OSAS: AHI > 1/h and the SaO2nadir <92% Subjects had no medical conditions apart from suspected OSAS secondary to ade-notonsillar hypertrophy, based on history. Patients with a history of prior treatment of OSAS (including lonsillectomy and adenoidectomy) referred for reevalu-ation were excluded from this study. Subjects were divided into preschool group and prepubertal group.(1) Preschool group; 28 children (16 boys and 12 girls) were included in this study. The mean age was 4. 3 +0. 7years. The mean body height was 105. 4 + 1. 2cm. The mean body weight was 18. 2 + 0. 6kg. The courses of diseases were from 0.5 to 4 vears.(2) Prepubertal group: 32 children (18 boys and 14 girls) were included in this study. The mean age -was 9. 0 +1.6 years. The mean body height was 131. 4 + 1. 3cm. The mean body weight was 28. 1 + 0. 8kg. The courses of diseases were from 0. 5 to 7 years.(2) Normal control: 20 aged - matched, asymptomatic and nonsnoring children who came for healthy physical exam were selected randomly as pre-schoolcontrol subjects. 23 aged -matched, asymptomatic and nonsnoring children who came for healthy physical exam were selected randomly as prepubertal control subjects.2. Methods:2. 1 All subjects were underwent overnight polysomnographic studies. The following parameters were included.(1) Sleep architecture; sleep parameters were continously recorded, including total recording time, total sleep time, sleep efficiency, non - rapid eye movement sleep ( stage 1 , stage2 and slow wave sleep, respectively) percentage , rapid eye movement sleep percentage and REM cycles.(2) Arousal index: the arousal index was calculated as the number of arous-als per hour of total sleep time.(3) Obstructive apnea and hypopnea; Obstructive apnea was defined as oro-nasal airflow suspending at least two respirator)1 cycles duration. Hypopneas were defined as a qualitative reduction in thermistor airflow 50% , associated with de-saturation 4% . AH1( apnea / hyponea index) was defined as the number of obstructive apnea and hypopnea per hour of total sleep time(4) The longest obstructive apnea duration (LAD)(5) SaO2: For assessment of arterial oxygen saturation, the SaO2nadir were determined.2.2 Achenbach Child Behavior Check List:To assess 4 ~ 12 years old children's behavior problem.2.3 Child attention test apparatus; To test prepubertal child's ability of attention.3. Statistical and analysis-.The data were analyzed with special statistical soft SPSS 11.0. Subjectswere compared with the controls using the two - tailed, unpaired t test. For non-parametric data, statistical analysis was performed using the Wilcoxon signed rank test. For enumeration data, statistical analysis was performed using chi -square test. Data that were normally distributed were expressed as mean + standard deviation; skewed data were shown as median. Ap value <0. 05 was considered significant statistically.Results1. Sleep architecture in children with OSAS(D In preschool study group, the total sleep time was 434. 3 +42. 3 min. Sleep efficiency was 88. 03 +8. 1%. The percentage of sleep stagel, stage 2, SWS and REM was 6. 03% , 41. 47% , 28. 12% and 24. 38% respectively. REM cycles were 4. There was no significant difference between the patients with OSAS... |
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