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Chinese Journal of Evidence -Based Pediatric ›› 2016, Vol. 11 ›› Issue (5): 327-331.

• Original Papers • Previous Articles     Next Articles

Analysis of characteristics of sleep and breathing parameters and risk factors in children with Duchenne muscular dystrophy

XU Man-ting1, FANG Fang1, XU Zhi-fei2, YANG Xin-ying1, LV Jun-lan1, LI Bei3   

  1. 1 Department of Neurology, 2 Department of Respiratory ,3 Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital of Capital Medical University, Beijing 100045, China
  • Received:2016-11-04 Revised:2016-11-04 Online:2016-10-25 Published:2016-10-25
  • Contact: FANG Fang；XU Zhi-fei

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Abstract:

Objective To analyze the characteristics of sleep and respiratory parameters and risk factors of sleep breathing disorder (SBD) in children with DMD. Methods Children with Duchenne muscular dystrophy (DMD), who had finished PSG and SBD related symptoms questionnaire in Beijing Children's Hospital affiliated to Capital Medical University, were retrospectively collected and divided into SBD group and non-SBD group based on the judgement of sleep stages and respiratory events. 7 sleep parameters and 7 respiratory parameters were presented, and 9 risk factors of SBD in children with DMD, selected from previous literatures, were analysed using single factor and multi factor analyses. Results 70 boys, whose mean age was (6.3±2.5) years old, were included. 66 cases completed percutaneous CO2 monitoring at the same time. Sleep time of doing PSG was 313~593（457±59）min, and sleep efficiency was 54%~98%［（86.7±8.1）%］. 25 patients were in SBD group and 45 patients were in non-SBD group. In the SBD group, none in patients aged 1 to 3 years, 8/23 in patients aged 4 to 6 years, 12/30 in patients aged 7 to 9 years, 5/5 in patients older than 10 years old. 14 patients were diagnosed as OSAHS. 18 cases had CO2 retention. 7 patients were presented with both OSAHS and CO2 retention. Compared with non-SBD group, patients in SBD group with the symptoms of sleep apnea phenomenon, asphyxia or shortness of breath at night, open mouth because of blocked nose and daytime sleep increasing were significantly increased. As to sleep parameters, patients in SBD group were more likely to wake up, more awake with events, more light sleep, less deep sleep, and lower sleep efficiency, the difference was statistically significant. As to respiratory parameters, there were significant differences between the two groups except for CAI. NSAA<13.5 scores (OR=3.4，95%CI：1.060-10.949) and age of doing PSG≥6 years （OR=7.3, 95%CI：1.426-37.463）increased the risk of suffering from SBD. Conclusion SBD occurred in the early stage of DMD patients, of which the risk increased with age. Motor function assessment may be a good predictor of SBD.