Article record

学龄儿童阻塞性睡眠呼吸暂停与学校功能相关临床障碍的纵向关联：一项多中心队列研究

Longitudinal associations of obstructive sleep apnea with clinical disorders relevant to school functioning in school-aged children: A multicenter cohort study.

临床研究咽喉科IF 4.5Q1

文献信息

PMID	42849379
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Yi-Pin Chang 查看其他 3 位作者 Jing-Jie Wang；Chia-Yi Tsai；Jui-Ju Tseng
作者单位	Department of Traditional Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. 查看其他 3 条单位信息 Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.；Department of Traditional Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.；Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan. Electronic address: loistseng66@gmail.com.
期刊	Sleep medicine
SCI 分区	Q1
IF	4.5
研究类型	临床研究 · 临床
所属专科	咽喉科

中文摘要

背景： 儿童阻塞性睡眠呼吸暂停（OSA）与学校功能困难相关，但证据主要依赖于神经认知、行为、学业和教育评估。我们检验了这些担忧是否也反映在纵向照护期间临床公认的学习、沟通和情绪领域障碍中。
方法： 这项回顾性多中心队列研究纳入了6-12岁经多导睡眠图支持的OSA且未接受腺扁桃体切除术（AT）的儿童，以及倾向评分匹配的健康对照。评估了1年、2年、3年和5年时学习障碍、言语和语言障碍、儿童期起病情绪障碍以及焦虑障碍的风险。次要比较检查了随后接受AT的儿童的5年模式。
结果： 主要分析纳入7136对匹配对。未接受AT的OSA与所有四个结局在所有随访期间的风险升高相关。5年时，学习障碍的风险比为1.86（95% CI，1.56-2.23），言语和语言障碍为2.25（1.82-2.77），儿童期起病情绪障碍为1.45（1.04-2.04），焦虑障碍为1.41（1.26-1.56）。次要比较显示，随后接受AT的儿童5年模式更有利。从健康对照中排除有记录的打鼾后，主要发现仍保持一致。
结论： 经PSG支持的未接受AT的OSA与随后记录的多个与学校功能相关领域的障碍存在纵向关联。这些发现表明，与儿童OSA相关的学校功能担忧也可能反映在纵向照护期间临床公认的障碍中。

英文摘要

BACKGROUND: Pediatric obstructive sleep apnea (OSA) has been associated with difficulties in school functioning, but evidence has largely relied on neurocognitive, behavioral, academic, and educational assessments. We examined whether these concerns are also reflected in clinically recognized disorders across learning, communication, and emotional domains during longitudinal care.
METHODS: This retrospective multicenter cohort study included children aged 6-12 years with polysomnography-supported OSA without adenotonsillectomy (AT) and propensity score-matched healthy controls. Risks of learning disorders, speech and language disorders, childhood-onset emotional disorders, and anxiety disorders were evaluated over 1, 2, 3, and 5 years. Secondary comparisons examined 5-year patterns involving children who subsequently underwent AT.
RESULTS: The primary analysis included 7136 matched pairs. OSA without AT was associated with higher risks of all four outcomes across all follow-up periods. At 5 years, hazard ratios were 1.86 (95% CI, 1.56-2.23) for learning disorders, 2.25 (1.82-2.77) for speech and language disorders, 1.45 (1.04-2.04) for childhood-onset emotional disorders, and 1.41 (1.26-1.56) for anxiety disorders. Secondary comparisons showed more favorable 5-year patterns among children who subsequently underwent AT. Primary findings remained consistent after excluding documented snoring from healthy controls.
CONCLUSIONS: PSG-supported OSA without AT was longitudinally associated with subsequently documented disorders across multiple domains relevant to school functioning. These findings suggest that school-functioning concerns associated with pediatric OSA may also be reflected in clinically recognized disorders during longitudinal care.