@article{oai:dmu.repo.nii.ac.jp:02000026,
 author = {今井,貫太 and Imai, Kanta and 中島, 逸男 and Nakajima, Itsuo and 春名, 眞一 and Haruna, Shinichi},
 issue = {1},
 journal = {Dokkyo Journal of Medical Sciences},
 month = {Jul},
 note = {小児睡眠呼吸障害には明確な診断や治療の基準がいまだ確立されていないことから，本邦では潜在患者も含めると相当数の患児が未治療のまま放置されている可能性がある．しかしながら診断に有用とされる睡眠ポリグラフ（polysomnography；以下PSG）検査を小児睡眠障害疑い例の全例に行うことは（小児医療のマンパワー不足や頻回な体動による電極の脱落などがあり，現実的にはほぼ不可能である．今回我々は，外科的治療の前後に検査施設外睡眠検査（out of center sleep testing；以下OCST）もしくはPSG検査で評価し得た小児閉塞性睡眠時無呼吸症候群の特徴について後方視的に検討した．
　対象は2006年4月から2021年3月までの16年間にいびきや睡眠時の呼吸障害を訴えて当院を受診した789症例のうち，OCSTで評価し得た392症例とPSG検査で評価し得た144例とした．そのうちアデノイド切除術・口蓋扁桃摘出術の前後でOCSTをし得た171例，PSG検査をし得た32例の各パラメーターをそれぞれ比較したところ，OCST群ではREI，ODIが有意に減少し，lowest SpO2が有意に増加し，PSG群ではAHI，無呼吸指数（AI），Oxygen Desaturation Index（ODI）が有意に減少し，stage REM（％）やREM睡眠時間は有意差をもって増加した（p＜0.05）．, Diagnostic and treatment criteria for obstructive sleep apnea （OSA） in children have not yet been established. Many of pediatric patients in Japan may remain undiagnosed and untreated. Polysomnography（PSG）is considered useful tool for the diagnosis of OSA. However, it is practically difficult to perform PSG in all pediatric OSA cases. The reasons for the difficulty of performing PSG in children are insufficient staffing and frequent body movements, which can lead to electrode dropout.
  In the present study, we retrospectively investigated the characteristics of pediatric OSA with out of center sleep testing（OCST）or PSG before and after otolaryngological surgical treatment. The study period was 16 years, from April 2006 to March 2021. The participants were 789 children under the age of 16 years. Most of all cases presented to our hospital with complaints of snoring or sleep-disordered breathing. Among them, 392 cases were assessed by OCST and 144 cases by PSG. The 171 cases with OCST and 32 cases with PSG before and after adenoidectomy and tonsillectomy were compared on various parameters. The results of our study showed that REI and ODI were significantly reduced in the OCST group. There was also a significant increase in lowest SpO2 in the OCST group. On the other hand, AHI, apnea index （AI）and oxygen desaturation index（ODII）were significantly decreased in the PSG group, while stage REM（％）and REM sleep duration increased with significant differences（p＜0.05）.
  Most pediatric OSA is a multifactorial condition, similar to adults. This means that it is necessary to assess the systemic impact of OSA, not only in the oral cavity, but also in nasal respiratory disease and obesity. Physical development and sleep are closely related in childhood development. Otolaryngologists should be more proactive and pay attention to diagnostic and therapeutic interventions for OSA in childhood.},
 pages = {37--45},
 title = {当科における小児閉塞性睡眠時無呼吸症候群の臨床像の検討},
 volume = {50},
 year = {2023}
}