合并阻塞性睡眠呼吸暂停的儿童在接受个体化多学科临床管理期间家长评定的注意缺陷/多动障碍症状评分及睡眠参数的变化：一项越南的前瞻性队列研究。
Changes in parent-rated attention-deficit/hyperactivity disorder symptom scores and sleep parameters during individualized multidisciplinary clinical management in children with comorbid obstructive sleep apnea: a prospective cohort study in Vietnam.
文献信息
| PMID | 42876905 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Mai Nguyen-Thi-Phuong |
| 作者单位 | Pediatric Department, Hanoi Medical University, Hanoi, Vietnam. |
| 期刊 | Frontiers in surgery |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 描述在接受个体化多学科临床管理的注意缺陷/多动障碍（ADHD）合并阻塞性睡眠呼吸暂停（OSA）儿童中，家长评定的ADHD症状评分、呼吸描记衍生参数及睡眠特征在6个月内的变化。
方法： 这项单臂前瞻性队列研究于2022年11月至2024年10月在越南国家儿童医院进行。在629名使用儿童睡眠问卷（PSQ）筛查的ADHD儿童中，293名至少有8个阳性回答并接受了家庭呼吸描记；147名具有与儿童OSA一致的临床特征并符合预设的呼吸描记标准，即呼吸事件指数（REI）≥1次/小时，141名完成了随访。在基线、3个月和6个月时评估家长评定的Vanderbilt ADHD诊断评定量表（VADRS）评分。在基线和6个月时评估呼吸描记和睡眠日记指标。
结果： 平均年龄为7.8岁，85.8%为男孩。6个月后，平均REI从11.8次/小时降至4.4次/小时，夜间最低外周血氧饱和度（SpO₂）从78.9%升至83.4%（均p < 0.001）。预设的呼吸描记严重程度分类向较轻类别转变（McNemar-Bowker χ 2[6] = 70.80，p < 0.001）；73名儿童（51.8%）至少改善一个类别，47名儿童（33.3%；95% CI，26.1-41.5%）在6个月时不再符合预设的OSA呼吸描记标准。入睡潜伏期和日间睡眠时长减少。夜间睡眠时长从8.4 ± 1.1小时增加至8.7 ± 0.6小时（平均变化，+0.3小时；95% CI，+0.14至+0.46；p < 0.001），而24小时总睡眠时长减少了0.5小时（p < 0.001）。家长评定的ADHD症状评分在所有VADRS领域均下降。
结论： 在6个月的个体化多学科临床管理期间，呼吸描记衍生指标、部分睡眠特征及家长评定的ADHD症状评分均改善。非对照设计和同时进行的干预措施使得无法将这些变化因果归因于针对OSA的治疗。
英文摘要
OBJECTIVE: To describe changes in parent-rated attention-deficit/hyperactivity disorder (ADHD) symptom scores, respiratory-polygraphy-derived parameters, and sleep characteristics over 6 months in children with ADHD and comorbid obstructive sleep apnea (OSA) who received individualized multidisciplinary clinical management.
METHODS: This single-arm prospective cohort study was conducted at Vietnam National Children's Hospital from November 2022 to October 2024. Among 629 children with ADHD screened using the Pediatric Sleep Questionnaire (PSQ), 293 had at least 8 positive responses and underwent home respiratory polygraphy; 147 had clinical features consistent with pediatric OSA and met the prespecified respiratory-polygraphy criterion of a respiratory event index (REI) ≥ 1 event/hour, and 141 completed follow-up. Parent-rated Vanderbilt ADHD Diagnostic Rating Scale (VADRS) scores were assessed at baseline, 3 months, and 6 months. Respiratory-polygraphy and sleep-diary measures were assessed at baseline and 6 months.
RESULTS: The mean age was 7.8 years, and 85.8% were boys. After 6 months, mean REI decreased from 11.8 to 4.4 events/hour, and the lowest nocturnal peripheral oxygen saturation (SpO₂) increased from 78.9% to 83.4% (both p < 0.001). Prespecified respiratory-polygraphy severity categories shifted toward less severe categories (McNemar-Bowker χ 2[6] = 70.80, p < 0.001); 73 children (51.8%) improved by at least one category, and 47 children (33.3%; 95% CI, 26.1-41.5%) no longer met the prespecified respiratory-polygraphy criterion for OSA at 6 months. Sleep-onset latency and daytime sleep duration decreased. Nighttime sleep duration increased from 8.4 ± 1.1 to 8.7 ± 0.6 h (mean change, +0.3 h; 95% CI, +0.14 to +0.46; p < 0.001), whereas total 24-h sleep duration decreased by 0.5 h (p < 0.001). Parent-rated ADHD symptom scores decreased across all VADRS domains.
CONCLUSION: Respiratory-polygraphy-derived indices, selected sleep characteristics, and parent-rated ADHD symptom scores improved during 6 months of individualized multidisciplinary clinical management. The uncontrolled design and concurrent interventions preclude causal attribution of these changes to OSA-directed treatment.