PDF(Pubmed)
Abstract：
Obstructive sleep-disordered breathing (SDB) has significant impacts on health, and therefore, a timely and accurate diagnosis is crucial for effective management and intervention. This narrative review provides an overview of the current approaches utilised in the diagnosis of SDB in children. Diagnostic methods for SDB in children involve a combination of clinical assessment, medical history evaluation, questionnaires, and objective measurements. Polysomnography (PSG) is the diagnostic gold standard. It records activity of brain and tibial and submental muscles, heart rhythm, eye movements, oximetry, oronasal airflow, abdominal and chest movements, body position. Despite its accuracy, it is a time-consuming and expensive tool. Respiratory polygraphy instead monitors cardiorespiratory function without simultaneously assessing sleep and wakefulness; it is more affordable than PSG, but few paediatric studies compare these techniques and there is optional recommendation in children. Nocturnal oximetry is a simple and accessible exam that has high predictive value only for children at high risk. The daytime nap PSG, despite the advantage of shorter duration and lower costs, is not accurate for predicting SDB. Few paediatric data support the use of home testing during sleep. Finally, laboratory biomarkers and radiological findings are potentially useful hallmarks of SDB, but further investigations are needed to standardise their use in clinical practice.
摘要：
阻塞性睡眠呼吸紊乱（SDB）对健康有重大影响，因此,及时准确的诊断对于有效的管理和干预至关重要。这篇叙述性综述概述了目前用于儿童SDB诊断的方法。儿童SDB的诊断方法涉及临床评估的组合，病史评估，问卷，客观的测量。多导睡眠图（PSG）是诊断的金标准。它记录了大脑、胫骨和下肌的活动，心律,眼球运动,血氧饱和度,口鼻气流,腹部和胸部运动，身体位置。尽管它的准确性，这是一个耗时且昂贵的工具。呼吸测谎仪可以监测心肺功能，而不同时评估睡眠和觉醒；它比PSG更实惠，但很少有儿科研究对这些技术进行比较,并且在儿童中有可选的建议.夜间血氧饱和度是一种简单且易于使用的检查，仅对高危儿童具有很高的预测价值。白天小睡的PSG，尽管期限短，成本低的优势，预测SDB不准确。很少有儿科数据支持在睡眠期间使用家庭测试。最后,实验室生物标志物和放射学发现是SDB的潜在有用标志，但是需要进一步的研究来规范它们在临床实践中的使用。
