X3 _( q/ S* _: f$ ~) i0 kExcessive Daytime Sleepiness More Common in Obese Children With Habitual Snoring 9 A/ c* A. b7 j1 K+ Q) ^ [公仔箱論壇 ' X }7 S' d& w, {- y; eTVBNOW 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。By Laurie Barclay, MD公仔箱論壇4 h0 X' p& |, z9 S; ` `
Medscape Medical News 公仔箱論壇$ z- L" p& o3 Q" V
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January 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.公仔箱論壇0 r7 s" n- c* z) o; \
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"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."* i4 O+ x M4 d1 K
o" D$ |% h5 W% A2 N% S, U# x" J公仔箱論壇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. 2 h! C' D' c3 O/ t5.39.217.77:8898 9 z6 i1 H. w7 k. QBoth 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.tvb now,tvbnow,bttvb% ~: f% r; V+ a* s% S
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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. : n- O& O; h. s+ B ) r" w% o" C6 V) Ytvb now,tvbnow,bttvb"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. # Z/ c9 U& b( v公仔箱論壇 8 ?# _' Y0 b1 Q$ m7 z: e0 ]tvb now,tvbnow,bttvbLimitations of this study include lack of encephalographic data and inability to determine biological mechanisms.tvb now,tvbnow,bttvb: K! K. Y# N7 ]$ c
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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." Y, D- D+ x! p9 d
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Dr. 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. % _) T% h4 E/ P" B. g3 Ltvb now,tvbnow,bttvb公仔箱論壇8 D4 x. q" \6 ~4 w7 B
Pediatrics. 2009;123:13-18
