摘要
目的探讨肥胖儿童的睡眠特点及存在的睡眠问题,并为肥胖儿童的睡眠监测和管理提供依据。方法选取2020年5月至12月南京医科大学附属儿童医院收治的68例肥胖儿童作为肥胖组,同时选取31例正常体质量健康儿童作为对照组,采用心肺耦合分析(cardiopulmonary coupling,CPC)和生命体征监护手环进行睡眠监测。比较两组的一般资料、睡眠总时间(total sleep time,TST)、在床时间(time in bed,TIB)、熟睡时间、最低动脉血氧饱和度(lowest oxygen saturation,LSaO2)、睡眠效率、3%氧减指数(3%oxygen desaturation index,ODI3)、夜醒时间等。比较两组阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的发生率及严重程度。分析身体质量指数Z评分(body mass index Z-score,BMI-Z值)与睡眠时间、睡眠呼吸、睡眠结构、睡眠效率的相关性。统计学方法采用t检验、χ^(2)检验、秩和检验和Pearson相关性分析。结果CPC结果显示,肥胖组的TST、TIB及熟睡时间均低于对照组,差异均有统计学意义(P值均<0.05)。生命体征监护手环结果显示,肥胖组的LSaO2、TST、TIB、睡眠效率均低于对照组,差异均有统计学意义(P值均<0.05);肥胖组的ODI3、夜醒时间均高于对照组,差异均有统计学意义(P值均<0.01)。肥胖组的OSAHS发生率明显高于对照组[63.2%(43/68)与35.5%(11/31),χ^(2)=6.614,P=0.010],且肥胖组的OSAHS程度较对照组严重(P<0.01)。Pearson相关性分析结果显示,BMI-Z值与TST(CPC)、TIB(CPC)、TST(生命体征监护手环)、TIB(生命体征监护手环)呈负相关(r值分别为-0.242、-0.337、-0.329、-0.202,P值均<0.05);与ODI3(手环)呈正相关(r=0.316,P=0.001),与LSaO2(生命体征监护手环)呈负相关(r=-0.262,P=0.009);与熟睡时间、有效熟睡时间呈负相关(r值分别为-0.215、-0.227,P值均<0.05);与睡眠效率(生命体征监护手环)呈负相关(r=-0.262,P=0.009),与夜醒时间(生命体征监护手环)呈正相关(r=0.215,P=0.033)。结论CPC和生命体征监护手环可以有效评估肥胖儿童的睡眠情况,尽早发现OSAHS等睡眠障碍。肥胖与不良的睡眠状况相关,主要包括睡眠时间少、入睡困难、睡眠呼吸紊乱、熟睡时间少、睡眠效率低、夜醒时间长。肥胖患儿控制体质量可能有助于改善睡眠状况。
Objective To explore the sleep characteristics and existing sleep problems of obese children,and to provide evidence for sleep monitoring and management of obese children.Method 68 obese children admitted to the Children's Hospital of Nanjing Medical University from May to December 2020 were selected as the obese group,while 31 healthy children with normal body weight were selected as the control group.Sleep monitoring was performed in the cardiopulmonary coupling(CPC)and the vital signs monitoring bracelet.General information,total sleep time(TST),time in bed(TIB),sleeping time,lowest oxygen saturation(LSaO2),sleep efficiency,and 3%oxygen desaturation index(ODI3)and night wake time of the two groups were compared.The incidence and severity of obstructive sleep apnea hypopnea syndrome(OSAHS)between the two groups were compared.The correlations between body mass index Z-score(BMI-Z)and sleep duration,sleep breathing,sleep structure and sleep efficiency were analyzed.Statistical methods performed by t-test,χ^(2)test and Pearson correlation analysis.Result CPC results showed that TST,TIB and sleeping time in the obese group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The results from the vital signs monitoring bracelet show that LSaO2,TST,TIB and sleep efficiency in the obese group were lower than those in the control group,the differences were statistically significant(all P<0.05);ODI3 and night wake time in the obese group were higher than those in the control group,and the differences were statistically significant(all P<0.01).The incidence of OSAHS in the obese group was significantly higher than that in the control group[63.2%(43/68)vs 35.5%(11/31),χ^(2)=6.614,P=0.010],and the degree of OSAHS in the obese group was more serious than that in the control group(P<0.01).The results of Pearson correlation analysis showed that BMI-Z scores were negatively correlated with TST(CPC),TIB(CPC),TST(vital signs monitoring bracelet),and TIB(vital signs monitoring bracelet)(r values were-0.242,-0.337,-0.329,-0.202,respectively,all P<0.05);positively correlated with ODI3(bracelet)(r=0.316,P=0.001),and negatively correlated with LSaO2(vital signs monitoring bracelet)(r=-0.262,P=0.009);negatively correlated with deep sleep time and effective deep sleep time(r values were-0.215,-0.227,all P<0.05);negatively correlated with sleep efficiency(vital signs monitoring bracelet)(r=-0.262,P=0.009),and positively correlated with nighttime awakening time(vital signs monitoring bracelet)(r=0.215,P=0.033).Conclusion The CPC and vital signs monitoring bracelet can be effective to assess the sleep status of obese children,helping early detection of sleep disorders such as OSAHS.Obesity is associated with poor sleep status,including less sleep time,difficulty falling asleep,sleep-disorganized breathing,less sleeping time,low sleep efficiency,and long night wake time.Weight control of obese children may help improve their sleep status.
作者
王冬妮
刘倩琦
陈冉
Wang Dongni;Liu Qianqi;Chen Ran(Department of Children Health Care,Children’s Hospital of Soochow University,Jiangsu,Suzhou 215025,China;Department of Children Health Care,Children’s Hospital of Nanjing Medical University,Jiangsu,Nanjing 210008,China)
出处
《发育医学电子杂志》
2025年第2期96-102,共7页
Journal of Developmental Medicine (Electronic Version)
基金
江苏省科技计划项目重点研发专项(BE2015607)。
