肥胖伴阻塞性睡眠呼吸暂停儿童的睡眠结构评估
Assessment of Sleep Architecture in Obese Children With Obstructive Sleep Apnea.
文献信息
| PMID | 42747109 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Hanna Y Gedamu |
| 作者单位 | Department of Otolaryngology - Head and Neck Surgery, University of Texas Southwestern Medical Center, Children's Medical Center, Dallas, Texas, USA. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 评估肥胖伴阻塞性睡眠呼吸暂停（OSA）儿童的睡眠，并确定OSA严重程度对其睡眠结构的影响。
方法： 回顾在儿童耳鼻喉科诊所就诊的OSA儿童的病历，收集体重指数分类、OSA严重程度和睡眠结构参数的信息，包括总睡眠时间（TST）、睡眠效率、睡眠潜伏期、非快速眼动睡眠各阶段（N1、N2和N3）比例、快速眼动睡眠（R期）以及入睡后觉醒时间（WASO）。使用多变量线性回归进行两两比较，统计学显著性定义为p < 0.05。
结果： 在461例OSA儿童（260例男性，201例女性）中，195例（42%）为肥胖。与健康体重儿童相比，II类肥胖[（β = -28.34，95% CI：[-49.36, -7.32]，p = 0.008）、（β = -4.25，95% CI：[-8.15, -0.34]，p = 0.033）]和III类肥胖[（β = -38.12，95% CI：[-58.83, -17.42]，p < 0.001）、（β = -5.69，95% CI：[-9.53, -1.84]，p = 0.004）]儿童的TST和睡眠效率降低。II类肥胖（β = 9.46，95% CI：[0.16, 18.75]，p = 0.046）和III类肥胖（β = 10.94，95% CI：[1.79, 20.09]，p = 0.019）儿童的WASO增加。I类肥胖（β = -1.94，95% CI：[-3.65, -0.22]，p = 0.027）和III类肥胖（β = -3.08，95% CI：[-5.06, -1.09]，p = 0.002）儿童的R期减少。III类肥胖儿童的N1%增加（β = 0.85，95% CI：[0.03, 1.67]，p = 0.043）。I类肥胖儿童的N3%增加（β = 7.27，95% CI：[2.81, 11.72]，p = 0.001）。睡眠潜伏期和N2%在不同肥胖类别之间无差异。BMI类别与TST（p = 0.004）、睡眠效率（p = 0.049）、N3%（p = 0.016）和REM%（p = 0.019）独立相关，而OSA严重程度与N1%相关（p < 0.001）。
结论： 在OSA儿童中，睡眠结构参数在不同肥胖类别之间存在差异。体重与睡眠结构之间的关系值得在伴或不伴OSA的儿童中进一步研究。
英文摘要
OBJECTIVES: To evaluate sleep in obese children with obstructive sleep apnea (OSA) and to determine the impact of OSA severity on their sleep architecture.
METHODS: Records of children with OSA seen in the pediatric otolaryngology clinic were reviewed to collect information on body mass index categories, severity of OSA, and sleep architecture parameters including total sleep time (TST), sleep efficiency, sleep latency, proportions of non-rapid eye movement sleep stages (N1, N2, and N3), rapid eye movement sleep (Stage R), and wake after sleep onset (WASO). Pairwise comparisons were performed using multivariable linear regression, with statistical significance defined as p < 0.05.
RESULTS: Out of 461 children with OSA (260 male, 201 female), 195 (42%) were obese. Compared to healthy weight children, TST and sleep efficiency decreased in Class II [(β = -28.34, 95% CI:[-49.36, -7.32], p = 0.008), (β = -4.25, 95% CI: [-8.15, -0.34], p = 0.033)] and Class III obesity [(β = -38.12, 95% CI: [-58.83, -17.42], p < 0.001), (β = -5.69, 95% CI:[-9.53, -1.84], p = 0.004)]. WASO increased in Class II (β = 9.46, 95% CI: [0.16, 18.75], p = 0.046) and Class III obesity (β = 10.94, 95% CI: [1.79, 20.09], p = 0.019). Stage R decreased in Class I obesity (β = -1.94, 95% CI: [-3.65, -0.22], p = 0.027) and Class III obesity (β = -3.08, 95% CI: [-5.06, -1.09], p = 0.002). N1% increased in Class III obesity (β = 0.85, 95% CI: [0.03, 1.67], p = 0.043). N3% increased in Class I obesity (β = 7.27, 95% CI: [2.81, 11.72], p = 0.001). Sleep latency and N2% were not different between obesity classes. BMI category was independently associated with TST (p = 0.004), sleep efficiency (p = 0.049), N3% (p = 0.016), and REM% (p = 0.019), while OSA severity was associated with N1% (p < 0.001).
CONCLUSIONS: Sleep architecture parameters differ across obesity classes in children with OSA. The relationship between weight and sleep architecture warrants further investigation in children both with and without OSA.