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儿童睡眠相关呼吸障碍的机制和易感因素

Author
Gerald M Rosen, MD
Section Editor
Ronald D Chervin, MD, MS
Deputy Editor
Alison G Hoppin, MD
Translators
唐勇军, 主治医师

引言

儿童正常是睡眠质量的金标准。儿童入睡前的睡眠潜伏期较短暂，然后在睡眠期间安静而舒适地呼吸，没有呼吸功增加的证据。睡眠效率是指睡眠时间与在床上的时间的比值，儿童的睡眠效率高，超过90%。儿童在夜间很少有行为觉醒，早上醒后精力充沛并准备学习和探索。在日间，儿童通常是非常警醒的，除间歇的小睡时间外，不会出现疲倦或困乏。

睡眠相关呼吸障碍也称为睡眠呼吸障碍，是一种异常的呼吸模式(包括呼吸暂停、低通气、呼吸努力相关性微觉醒)，或是气体交换异常减少(通气不足)，表现为睡眠期间上呼吸道反复出现部分或完全梗阻发作。儿童睡眠相关呼吸障碍可发生于严重程度不同的一系列疾病，从轻度的习惯性打鼾到严重的阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)。

本专题将讨论儿童睡眠的正常生理学以及干扰睡眠期间呼吸和促使睡眠相关呼吸障碍(包括OSA)发生的因素。对打鼾或疑似OSA儿童的评估和OSA儿童的治疗将单独讨论。(参见“儿童疑似阻塞性睡眠呼吸暂停的评估”和“儿童阻塞性睡眠呼吸暂停的治疗”)

睡眠分期

6个月龄后，儿童的睡眠可分为快速眼动(rapid eye movement, REM)睡眠期和非快速眼动(non-rapid eye movement, NREM)睡眠期，可使用美国睡眠医学学会(American Academy Of Sleep Medicine, AASM)睡眠及相关事件评分手册通过多导生理记录仪进行评分[1]。(参见“正常睡眠的分期和结构”和“儿童睡眠生理”，关于‘睡眠状态’一节)

REM睡眠是生理上较活跃的睡眠状态，表现为：

                     

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Literature review current through: 2017-06 . | This topic last updated: 2017-01-10.
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