Objective To evaluate the quality of life (QoL) and its influencing factors in children with obstructive sleep apnea (OSA), providing a reference for clinical intervention. Methods A total of 527 children who underwent overnight polysomnography (PSG) at the Second Affiliated Hospital of Xi′an Jiaotong University between 2021 and 2023 were enrolled.Under the guidance of professional technicians, participants completed the Pediatric Sleep Questionnaire, the Epworth Sleepiness Scale for Children and Adolescents, and the OSA-18 quality of life survey.Based on PSG results, children were categorized into groups to assess QoL.Further stratification was performed according to OSA-18 scores into mild, moderate, and severe impact groups.Statistical analysis was conducted using univariate analysis and ordered multivariate logistic regression. Results Among the 527 children, 116 (22.0%) were in the primary snoring group, 310 (58.8%) in the mild OSA group, and 101 (19.2%) in the moderate-to-severe OSA group.As OSA severity increased, the proportion of children with snoring and apnea significantly rose (both P<0.05).Additionally, the percentage of children falling asleep within 20 minutes of bedtime (χ2=6.599, P=0.037) and requiring prolonged wakefulness after rising (χ2=25.617, P<0.001) also increased significantly.OSA-18 scores indicated a progressive deterioration in QoL with disease severity (χ2=17.74, P=0.001).When stratified by QoL impact, significant differences were observed among groups in N3 sleep proportion, total obstructive event count, longest obstructive event duration, total mixed event count, longest mixed event duration, total hypopnea count, longest hypopnea duration, lowest oxygen saturation (SaO2), apnea-hypopnea index, and oxygen desaturation index (all P<0.05).Ordered multivariate logistic regression identified lowest SaO2 as an independent influencing factor for reduced QoL (OR=0.861, 95%CI:0.746~0.993,P=0.040). Conclusions Compared with primary snoring, OSA exerts a progressively greater impact on children′s QoL as disease severity increases.Furthermore, lowest SaO2 is an independent protective factor for diminished QoL, warranting clinical attention.
Key words
obstructive sleep apnea /
life quality /
children
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Astill RG, van Der Heijden KB, Van Ijzendoorn MH, et al.Sleep, cognition, and behavioral problems in school-age children: A century of research Meta-analyzed[J].Psychol Bull, 2012, 138(6): 1109-38.
[2] Lane SJ, Leão MA, Spielmann V.Sleep, sensory integration/processing, and autism: A scoping review[J].Front Psychol, 2022, 13: 877527.
[3] 杨军, 谢宇平, 马薇, 等.儿童阻塞型睡眠呼吸暂停对认知功能损伤的研究进展[J].神经损伤与功能重建, 2022, 17(07): 396-398,419.
Yang J, Xie YP, Ma W, et al.Research progress on cognitive impairment caused by obstructive sleep apnea in children[J].Neural Injury and Functional Reconstruction, 2022, 17(7): 396-398, 419.(in Chinese)
[4] Wang YG, Menno D, Chen A, et al.Validation of the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) questionnaire in pediatric patients with narcolepsy with cataplexy aged 7-16 years[J].Sleep Med, 2022, 89: 78-84.
[5] Csábi E, Gaál V, Hallgató E, et al.Increased behavioral problems in children with sleep-disordered breathing[J].Ital J Pediatr, 2022, 48(1): 173.
[6] Huang YS, Guilleminault C.Pediatric obstructive sleep apnea: Where do we stand?[J].Adv Otorhinolaryngol, 2017, 80: 136-144.
[7] 倪鑫.中国儿童阻塞性睡眠呼吸暂停诊断与治疗指南(2020)[J].中国循证医学杂志, 2020, 20(8): 883-900.
Ni X.Diagnosis and treatment guidelines for obstructive sleep apnea in Chinese children[J].Chinese Journal of Evidence-Based Medicine, 2020, 20(8): 883-900.(in Chinese)
[8] Singla V, Gattu T, Aggarwal S, et al.Evaluation of Epworth Sleepiness Scale to Predict Obstructive Sleep Apnea in morbidly obese patients and increasing its utility[J].J Laparoendosc Adv Surg Tech A, 2019, 29(3): 298-302.
[9] Franco R, Rosenfeld R, Rao M.First place--resident clinical science award 1999.Quality of life for children with obstructive sleep apnea[J].Otolaryng Head Neck Surg, 2000, 123: 9-16.
[10] 王晓晔, 丁秀, 王小轶,等.OSA-18量表筛查儿童阻塞性睡眠呼吸暂停综合征的研究[J].中国耳鼻咽喉头颈外科, 2023, 30(2): 111-115.
Wang XY, Ding X, Wang XY, et al.Study on the OSA-18 questionnaire for screening obstructive sleep apnea syndrome in children[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2023, 30(2): 111-115.(in Chinese)
[11] Shafiek H, Evangelisti M, Abd-Elwahab NH, et al.Obstructive sleep apnea in school-aged children presented with nocturnal enuresis[J].Lung, 2020, 198(1): 187-194.
[12] Assadi MH, Segev Y, Tarasiuk A.Upper airway obstruction elicited energy imbalance leads to growth retardation that persists after the obstruction removal[J].Sci Rep, 2020, 10(1): 3206.
[13] Bokov P, Dudoignon B, Spruyt K, et al.Alteration of sleep architecture in children with obstructive sleep apnea syndrome[J].Sleep, 2023, 46(11):zsad170.
[14] Gipson K, Lu M, Kinane TB.Sleep-disordered breathing in children[J].Pediatr Rev, 2019, 40(1): 3-13.
[15] Sistla SK, Lahane V.OSA 18 Questionnaire: Tool to evaluate quality of life and efficacy of treatment modalities in pediatric sleep disordered breathing due to adenotonsillar hypertrophy[J].Indian J Otolaryngol Head Neck Surg, 2022, 74(Suppl 3): 6406-6413.
PDF(3333 KB)
