One hundred questions and answers about children′s sleep health in China / 中华实用儿科临床杂志

Good sleep is essential for children′s physical and mental health, growth, and development.Adequate and high-quality sleep positively impacts children′s quality of life, memory, learning, attention, mood, and behavior.Children of different ages have different sleep needs.Children have various sleep problems in different cultures.Therefore, it is significant to guide children to get healthy sleep by popularizing the sleep problems of Chinese children of all ages and in all dimensions.Based on China′s social and cultural background, this paper summarizes the contents related to children′s sleep physiology, good sleep habits, common sleep problems, sleep apnea disorders, hypnagogic sleep, narcolepsy, insomnia, and other issues that interfere with children′s sleep.Chinese sleep experts summarize and interpret the 100 sleep health problems of children that medical workers and parents are most concerned about.To promote children′s sleep health and popularize solutions to sleep problems.

Clinical value of portable sleep testing in children with obstructive sleep apnea syndrome / 中华儿科杂志

<p><b>OBJECTIVE</b>To determine the clinical value of portable sleep testing by Watch-PAT (PAT) in children with obstructive sleep apnea syndrome (OSAS).</p><p><b>METHOD</b>Fifty cases of snoring children aged 3-11 years were randomly selected to undergo the polysomnography (PSG) and PAT simultaneously at the same night. The consistency of sleep parameters in OSAS and non - OSAS children were compared with PSG as reference standard, and ROC curve analysis was performed to assess the sensitivity and specificity in the diagnosis of OSAS with PAT portable sleep monitor.</p><p><b>RESULT</b>Fourteen cases were diagnosed as OSAS in 6-11 years group by PAT and PSG. But in 3-5 years group, only six children were diagnosed as OSAS, there was significant difference between PAT and PSG (P < 0.05). Among those 6-11 years old children, compared with non-OSAS, PAT study showed that III+IV stage sleep ((30.5 ± 2.4)% vs. (38.2 ± 2.3)%, χ(2)=4.31, P<0.05), REM sleep duration ((8.9 ± 2.5)% vs. (18.3 ± 2.1)%, χ² =4.31, P<0.05), TST ((458 ± 78) min vs. (522 ± 56) min, t=4.85, P<0.05) and sleep efficiency ((83.5 ± 3.1)% vs. (93.5 ± 3.5)%, t=3.75, P<0.05) decreased, I+II stage sleep ((61.5 ± 4.4)% vs. (44.1 ± 3.5)%, χ² =6.07, P<0.05), arousal index ((29.5 ± 8.2)/h vs. (10.6 ± 5.6)/h, t=3.70, P<0.05), AHI ((7.6 ± 5.3)/h vs. (2.1 ± 2.0)/h, t=2.40, P<0.05), RDI((18.2 ± 5.1)/h vs. (6.5 ± 3.9)/h, t=3.85, P<0.05) increased in OSAS children. Furthermore, the total sleep time (TST) ((458 ± 78) min vs. (430 ± 76) min, t=2.90, P<0.05) and sleep efficiency ((83.5 ± 3.1) % vs. (81.9 ± 4.3) %, t=2.45, P<0.05) were higher by PAT than scored by PSG. ROC curve analysis showed the best threshold selection of AHI 5.0, the sensitivity was 0.952, the specificity was 0.858. AHI 7.0, the sensitivity was 0.968, the specificity was 0.985. AHI 10, the sensitivity was 0.985 and the specificity was 0.99, but AHI 1.0, the sensitivity was 0.852 and the specificity was 0.785.</p><p><b>CONCLUSION</b>PAT can be used at home in school age children due to the high consistency with PSG and the high compliance.</p>

A comparative study on efficiency of different therapeutics methods used for obstructive sleep apnea hypopnea syndrome in children / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate effectiveness therapeutic regimens for obstructive sleep apnea hypopnea syndrome (OSAHS) children at an acceptable cost.</p><p><b>METHOD</b>This study was performed at Yuying Children's Hospital of Wenzhou Medical University from Mar. 2008 to Dec. 2010. Prospective random number table method was used for the analysis; 60 children with mild OSAHS were divided into Mild OSAHS Montelukast Treatment (MM) group and Mild OSAHS Adenotonsillectomy Treatment (MAT) group. 32 children in MM group were treated with leukotriene receptor antagonists (LTRAs), while 28 children in MAT group were treated with adenotonsillectomy. Also, 58 children with moderate and severe OSAHS were divided into severe OSAHS Montelukast Treatment (SM) group and severe OSAHS Adenotonsillectomy Treatmen (SAT) group. Twenty-two children in SM group were treated with LTRAs, while 36 children in SAT group were treated with adenotonsillectomy. All selected children were evaluated by polysomnography (PSG) and Obstructive Sleep Apnea-18 (OSA-18) items before and after a six-month treatment. Both records were taken and analyzed, surgical complications and the reason for non-remission after operation were also analyzed. Two therapies were compared based on economic consideration and therapeutic effect. Result (1) PSG: A significant change of a significant change of Apnea Hypopnea Index (AHI) was observed in MM group after the treatment (before receiving the treatment 4.56 ± 1. 26, and after receiving the treatment 3. 48 ± 1. 52, t =3. 50, P <0. 05). But for oxygen desaturation Index (ODI) (MM group 2. 18 ± 2. 19, and MAT group 1. 80 ± 2. 34) and Lowest Oxygen satuation (LSaO2) (MM group 91. 66 ± 2. 34, and MAT group 92. 79 ± 2. 18), there was no significant difference in MM group and MAT group after the treatment (ODI, t =0. 65, and LSaO2 t = - 1. 93, P >0. 05). (2) OSA-18 scores: Significant differences were found in sleeping disorder (before 14. 81 ± 6. 28, and after 10. 56 ± 3. 57), the degree of familial stress (before 13. 56 ± 3. 54, and after 8. 97 ± 2. 96), and OSA-18 total scores (before 52. 66 ± 1. 11, and after 42. 56 6. 48) in MM group after the treatment (sleeping disorder Z - 3. 14, the degree of familial stress Z = -4. 50, and OSA-18 total scores Z= -4. 01, P <0. 05). (3) In addition to the cost of drugs, groups with surgical treatment had a larger economic burden than those with LTRAs treatment. (4) Treatment was totally effective for 28 children (88%) in MM group, and 28 children (100%) in MAT group. Meanwhile, treatment also achieved an obvious effect on 2 children (9%) in SM group, and in 35 children (97%) in SAT group. In MAT group, 3 children improved (11%). And in SAT group, 7 children improved (19%), but treatment was found to be ineffective in 1 case (3%). Among those effective and ineffective cases in groups with surgical treatment, there were 9 children with nasal diseases.</p><p><b>CONCLUSION</b>(1) Surgical treatment is recommended as the first choice for children with moderate and severe OSAHS. And for those who also suffer from nasal diseases, treatment combining drugs with surgery is necessary. (2) LTRAs therapy has a good effect for mild OSAHS. Surgery is also recommended when drugs could not achieve any obvious improvement in clinical symptoms of children with mild OSAHS.</p>

Effect of chronic intermittent hypoxia on memory and CREB expression in growing rats / 中国病理生理杂志

AIM:To observe the alterations in cognition of growing rats exposed to chronic intermittent hypoxia (CIH) and to explore its underlying mechanisms. METHODS:Forty male Sprague-Dawley rats (3-week-old～4-week-old and 80 g to 100 g),which had been trained to complete the 8-arm (4-arm baited) radial maze,were randomly divided into 4 groups:2-weeek-CIH group (2IH),4-week-CIH group (4IH),-week -control group (2C) and 4-weeek-control group (4C). The intermittent hypoxia model was induced by putting the animals in an intermittent hypoxia cabin. When intermittent hypoxia was terminated,spatial memory of these growing rats was tested by 8-arm (4-arm baited) radial maze task,then,one rat in each group was randomly selected for ultrastructural observation. The hippocampus and prefrontal cortexes of the rats were collected for analyzing the mRNA and protein expression of CREB by RT-PCR and Western blotting,respectively. RESULTS:(1) In the 8-arm (4-arm baited) radial maze task,the results indicated that the rats in the 4 groups displayed significant difference in their performance assessed by three measuremens:the reference memory error,the working memory error and total memory error (P 0. 05,respectively). CONCLUSION:Exposure to experimentally-induced IH in growing rats is associated with time related spatial memory impairment. Chronic intermittent hypoxia leads to the disorders of neuron ultra-structure in memory related brain regions. It also inhabits the CREB transduction,expression and CREB phosphorylation,decreases the synthesis of the memory related protein. These factors maybe contribute to learningmemory impairment of growing rats exposed to chronic intermittent hypoxia.