PREVALENCE OF SLEEP DISORDERED BREATHING IN CHILDREN

儿童睡眠呼吸障碍的患病率

• 批准号: 6642857
• 负责人: Edward O. Bixler
• 金额: $ 26.93万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-01 至 2006-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6642857
• 关键词: academic achievement; cardiovascular function; child behavior; child physical development; clinical research; disease /disorder proneness /risk; epidemiology; family structure /dynamics; human subject; middle childhood (6-11); questionnaires; respiratory airflow disorder; sleep apnea; sleep disorders

DESCRIPTION (provided by applicant): The objectives of this proposal are to: 1) establish the prevalence of different types of sleep disordered breathing (SDB) in a large general random sample of children; 2) identify important risk factors of SDB; (3) establish the family history of various risk factors associated with children with SDB; (4) assess the impact of SDB on clinical, psychometric and behavioral/academic outcomes; and 5) identify characteristics which will assist in identifying those children at risk for SDB for possible early intervention. Several studies evaluating select populations have suggested that various severe consequences are associated with SDB in children. These consequences include: cardiovascular complications such as pulmonary hypertension, cor pulmonale, and arrhythmia; behavioral abnormalities such as excessive daytime sleepiness, poor school performance, hyperactivity, aggressive behavior, and social withdrawal; and growth disturbances which at times are reversed by successful treatment. To date, there have been only four studies evaluating the prevalence of sleep apnea using objective sleep evaluation methods in general random samples of children. Three studies evaluated a limited age range of 6 mos to 6 yrs, while the fourth assessed a range of 2-18 years. These studies employed relatively small samples in their sleep laboratory phase (N=lO, 11, 132, and 126, respectively). Thus, they could not adequately assess clinical significance. None of these studies evaluated: general development (eg height, weight, age adjusted BMI); the effects of SDB on physical health (eg blood pressure); academic achievement; or electrophysiologic defined sleep stages as possible outcome measures. Only one study reported a possible association with daytime sleepiness and behavior. Thus, the prevalence and clinical impact of SDB in school age children is unknown. In order to establish the prevalence and clinical significance of SDB in children aged 6 - 12 years with reasonable precision, we propose to employ a protocol similar to that used to establish the prevalence and clinical significance in two previously NIH supported protocols in adults. The proposed study will employ a two-phase protocol: 1) questionnaire completed by the parents of every child enrolled in local elementary school which will assess general sleep, behavior and learning problems; 2) a random sample (n= 1,000) selected from the first sample based on risk for SDB and evaluated in the sleep laboratory to determine the presence of SDB. The second phase will receive a thorough pediatric ENT and pulmonary evaluation and school records and behavior will be assessed. The parents of this group will be interviewed for the family history of risk factors associated with SDB in children. This strategy will yield adequate power to establish the prevalence and clinical significance of SDB in children.

描述（由申请人提供）：本提案的目标是：1） 建立不同类型的睡眠失调呼吸（SDB）的患病率 在大量的一般随机样本中； 2）确定重要风险 SDB的因素； （3）建立各种风险因素的家族史 与SDB儿童有关； （4）评估SDB对临床的影响， 心理和行为/学术成果； 5）确定特征 这将有助于确定那些有SDB风险的孩子 早期干预。评估某些人群的几项研究 提出各种严重的后果与儿童的SDB有关。 这些后果包括：心血管并发症，例如肺部并发症 高血压，肺部和心律不齐；行为异常，例如 白天过度嗜睡，学校表现不佳，多动症， 侵略性行为和社会撤退；和成长障碍 成功治疗可以逆转时间。迄今为止，只有四个 使用客观睡眠评估睡眠呼吸暂停患病率的研究 一般的儿童随机样本中的评估方法。三项研究 评估了6个月至6年的有限年龄范围，而第四个评估了A 2 - 18年的范围。这些研究在其中采用了相对较小的样本 睡眠实验室阶段（分别为N = LO，11、132和126）。因此，他们可以 不能充分评估临床意义。这些研究均未评估： 一般发展（例如身高，体重，年龄调整后的BMI）； SDB的影响 关于身体健康（例如血压）；学术成就；或者 电生理定义的睡眠阶段是可能的结果指标。只有一个 研究报告了可能与白天的嗜睡和行为有关联。 因此，SDB在学龄儿童中的患病率和临床影响是 未知。为了确定SDB的患病率和临床意义 在6至12岁的儿童中，我们建议使用 与用于建立患病率和临床的协议相似 在成人的两个先前支持的两种支持方案中的显着性。提议 研究将采用两相协议：1）调查表由 每个入学的孩子的父母，都将评估 一般的睡眠，行为和学习问题； 2）随机样本（n = 1,000） 根据SDB的风险从第一个样本中选择并在睡眠中进行评估 实验室确定SDB的存在。第二阶段将获得 彻底的儿科和肺部评估以及学校记录和行为 将被评估。该小组的父母将接受家庭采访 与儿童SDB相关的危险因素史。这个策略将 产生足够的能力，以确立 儿童的SDB。