8 q Q6 h% R; k( p+ i: E I- I; yTVBNOW 含有熱門話題，最新最快電視，軟體，遊戲，電影，動漫及日常生活及興趣交流等資訊。作者：Laurie Barclay, MD
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; F# R, r+ e3 N( `/ F) V& w C/ ^ January 5, 2009 — 根據1月份的小兒科期刊，相較於不肥胖的打鼾小孩，有習慣性打鼾的肥胖小孩更常見過度日間睡眠(Excessive daytime sleepiness，EDS)。 TVBNOW 含有熱門話題，最新最快電視，軟體，遊戲，電影，動漫及日常生活及興趣交流等資訊。0 G( P. A. a- \8 g
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肯塔基路易斯維爾大學與Kosair兒童醫院研究中心的David Gozal醫師與Leila Kheirandish-Gozal醫師寫道，在評估習慣性打鼾方面，孩童期肥胖的流行病學促進了有症狀過重或肥胖小孩的顯著改變；不過，仍然不清楚肥胖是否改變了過度日間睡眠等日間症狀的頻率。
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這項研究的樣本包括50名不肥胖、大致健康的小孩，以及50名年齡、性別與種族相符的肥胖小孩。年齡範圍從6-9歲，肥胖小孩的身體質量指數 z 分數大於1.67；所有參與者接受整夜的多頻睡眠生理檢查偵測儀評估，接著在追蹤期間進行多重睡眠潛伏期試驗。
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/ q' C1 J, S4 ? ^6 |% j' g+ L 兩組的平均阻塞性呼吸中止/低通氣（通氣不足）指數相似，在不肥胖小孩的完整睡眠時間內每小時為12.0 ± 1.7，肥胖小孩為10.9 ± 1.5。不過，相較於不肥胖的小孩，肥胖小孩的平均睡眠潛伏期較短(12.9 ± 0.9分鐘相較於17.9 ± 0.7分鐘)。平均睡眠潛伏期為12.0分鐘以下者，肥胖小孩有21名，不肥胖小孩有5名。8 q; l8 V+ z# `, ? `9 f
- l/ k x2 C5 a9 N$ n; V$ @- e 至於所有研究對象，平均睡眠潛伏期、阻塞性呼吸中止/低通氣（通氣不足）指數、氧氣飽和度小於95%的全部睡眠時間、呼吸覺醒指數等之間有顯著關聯；不過，肥胖小孩組的平均睡眠潛伏期和這些變項之線性關聯的斜率和交叉點較大。3 e& [! w3 M( a7 [% C
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研究作者寫道，任何程度的阻塞性睡眠呼吸中止(obstructive sleep apnea [OSA])中，肥胖小孩的過度日間睡眠可能性大於不肥胖的小孩，顯著連結到成人阻塞性睡眠呼吸中止的過度日間睡眠模式。
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9 p' j9 ]! B; }( J" _ 研究限制包括缺乏腦部攝影的資料，無法確認生物機轉。公仔箱論壇8 E8 Y2 C! j5 D
7 A' X3 l X- w3 ]0 @TVBNOW 含有熱門話題，最新最快電視，軟體，遊戲，電影，動漫及日常生活及興趣交流等資訊。 研究作者結論表示，當OSA的嚴重度相似時，肥胖小孩的EDS風險增加。再者，不論OSA嚴重度，肥胖、習慣性打鼾的小孩的MSL [多重睡眠潛伏期(即增加嗜睡傾向)]顯著減少。因此，肥胖小孩臨床出現習慣性打鼾以及睡眠異常呼吸時不同於那些不肥胖的小孩，諸如EDS症狀和嚴重度都提醒我們要為肥胖小孩增加OSA評估。tvb now,tvbnow,bttvb0 `' d2 ~9 f% o, m# ^: g, Q
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Gozal醫師接受國家健康研究中心、兒童基因會睡眠研究資金、肯塔基精進信託基金協會的支持。Kheirandish-Gozal醫師接受國家太空局的支持
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5 L1 x' c) S8 \1 H6 Etvb now,tvbnow,bttvbExcessive Daytime Sleepiness More Common in Obese Children With Habitual Snoring 3 O/ _0 I2 ?: {8 \3 F' E4 K
TVBNOW 含有熱門話題，最新最快電視，軟體，遊戲，電影，動漫及日常生活及興趣交流等資訊。1 D5 s% B" v- L2 Y
By Laurie Barclay, MD
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+ c( H5 L8 W# |$ Q5 Q8 U) RJanuary 5, 2009 — Excessive daytime sleepiness (EDS) is significantly more common in obese children with habitual snoring vs nonobese snoring children, according to the results of a study reported in the January issue of Pediatrics.TVBNOW 含有熱門話題，最新最快電視，軟體，遊戲，電影，動漫及日常生活及興趣交流等資訊。% H- S9 |% W% `* J" e* o
7 x+ ^# r* s W" ^3 }( y"The epidemic of childhood obesity has prompted remarkable changes in the relative proportions of symptomatic overweight or obese children being referred for evaluation of habitual snoring," write David Gozal, MD, and Leila Kheirandish-Gozal, MD, from Kosair Children's Hospital Research Institute and University of Louisville in Kentucky. "However, it remains unclear whether obesity modifies the relative frequency of daytime symptoms such as excessive daytime sleepiness."
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The study sample consisted of 50 consecutive, nonobese, habitually snoring, otherwise healthy children and 50 obese children matched for age, sex, and ethnicity. Age range was 6 to 9 years, and body mass index z score in the obese children was greater than 1.67. All participants had an overnight polysomnographic evaluation, followed by a multiple sleep latency test on the following day.
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6 ~) h k+ V% Z: }! q* ?" sBoth groups had similar mean obstructive apnea/hypopnea index values, with episodes per hour of total sleep time 12.0 ± 1.7 in nonobese children vs 10.9 ± 1.5 in obese children. Compared with nonobese children, however, obese children had significantly shorter mean sleep latency (12.9 ± 0.9 minutes vs 17.9 ± 0.7 minutes). Mean sleep latencies were 12.0 minutes or less in 21 obese children but in only 5 nonobese children.
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For the whole cohort, there were significant associations among mean sleep latency, obstructive apnea/hypopnea index, proportion of total sleep time with oxygen saturation of less than 95%, and respiratory arousal index. However, the slopes and intersects of the linear correlation of mean sleep latency with any of these variables were consistently greater in the group of obese children.公仔箱論壇. U" u7 c0 O2 W& c8 A# \
0 s/ O% M0 ~. ^$ |) {$ x; B9 ^TVBNOW 含有熱門話題，最新最快電視，軟體，遊戲，電影，動漫及日常生活及興趣交流等資訊。"The likelihood of excessive daytime sleepiness for obese children is greater than that for nonobese children at any given level of obstructive sleep apnea [OSA] severity and is strikingly reminiscent of excessive daytime sleepiness patterns in adults with obstructive sleep apnea," the study authors write.
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Limitations of this study include lack of encephalographic data and inability to determine biological mechanisms.
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"In the presence of OSA of similar severity, obese children are at increased risk for EDS," the study authors conclude. "Furthermore, obese, habitually snoring children present magnified reductions in MSL [multiple sleep latency] (ie, increased sleep propensity) at any level of OSA severity. Therefore, the clinical presentation of habitual snoring and sleep-disordered breathing in obese children differs from that of children who are not obese, such that symptoms of EDS and difficulty remaining awake for an obese child should prompt evaluation for OSA."tvb now,tvbnow,bttvb& `6 J# H9 C5 y2 f
$ L4 Y6 E% c+ c0 w3 nDr. Gozal was supported by the National Institutes of Health, the Children's Foundation Endowment for Sleep Research, and the Commonwealth of Kentucky Challenge for Excellence Trust Fund. Dr. Kheirandish-Gozal has received support from the National Space Agency.公仔箱論壇) F1 A' U; W" Y
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Pediatrics. 2009;123:13-18 |
發表於 2009-1-16 10:08 AM
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