打鼾的孩子可能有患高血压和心脏病的风险

阻塞性睡眠呼吸暂停, 睡眠障碍以呼吸中断为特征的一种睡眠障碍, may be linked to changes in blood pressure and heart structure in children and adolescents, 根据一项新的科学声明.

The 美国心脏协会 report urges parents and health care providers to consider testing for children who exhibit symptoms, 肥胖或扁桃体肿大, 这让他们面临更高的风险.

Estimates show up to 6% of all children and adolescents have obstructive sleep apnea, 根据周三发表在《沙巴足球体育平台》上的声明 美国心脏协会杂志.

阻塞性睡眠呼吸暂停的症状包括习惯性打鼾, gasps, 睡觉时打鼾或呼吸困难, 白天嗜睡, 伸直脖子坐着睡觉, 醒来时头痛，有上呼吸道阻塞的症状. 这种情况经常发生在肥胖儿童身上. About 30%-60% of children who meet the criteria for obesity – having a body mass index in the 95th percentile or higher – also have sleep apnea.

"We need to increase awareness about how the rising prevalence of obesity may be impacting sleep quality in kids and recognize sleep-disordered breathing as something that could contribute to risks for hypertension and later cardiovascular disease,声明写作小组主席. Carissa M. 贝克-史密斯在沙巴足球体育平台发布会上说. Baker-Smith is director of pediatric preventive cardiology at the Nemours/Alfred I. 特拉华州威尔明顿的杜邦儿童医院. She also is associate professor of pediatric cardiology at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia.

阻塞性睡眠呼吸暂停 is associated with cardiovascular disease in adults but less is known about how the condition affects the immediate and long-term heart health of children and adolescents. A review of the most current research included in the statement found evidence it can impact emotional health, 免疫者也一样, 儿童和青少年的代谢和心血管系统.

阻塞性睡眠呼吸暂停的危险因素随年龄而变化. 除了肥胖, they include upper and lower airway disease; allergic rhinitis, inflammation and swelling in the nose's mucous membrane; low muscle tone; enlarged tonsils and adenoids; craniofacial malformations; and neuromuscular disorders. 镰状细胞病这是一种遗传性血液疾病，也是一个危险因素.

早产儿童, who have delayed development of respiratory control and smaller upper airways, 也可能有更高的睡眠呼吸障碍的风险. 然而，随着孩子的成长，这种风险会越来越小.

The statement supports recommendations from the American Academy of Otolaryngology and Head and Neck Surgery that say sleep studies, 或多导睡眠描记术, 诊断睡眠呼吸障碍的最佳测试是什么. 在扁桃体切除术之前, children should take this test if they have conditions that raise their risk for breathing complications during surgery. 包括肥胖, Down syndrome, 颅面畸形，如腭裂, 以及肌肉萎缩症或镰状细胞病等疾病.

Children and adolescents with obstructive sleep apnea also may have trouble regulating blood pressure. 而血压通常在睡眠时下降, 有这种情况的孩子比没有这种情况的孩子看到更小的下降. Adults whose blood pressure fails to dip during sleep have a higher risk for cardiovascular events. Because of this, the statement calls for 24-hour blood pressure monitoring to check levels in children with sleep apnea.

Even mild cases of sleep apnea – defined as just two pauses in breathing per hour – are associated with a higher risk for metabolic syndrome in children. Metabolic syndrome is a cluster of factors including high insulin and triglyceride levels, 高血压和低水平的高密度脂蛋白, or HDL, “好”胆固醇. 持续气道正压, or CPAP, is a treatment for sleep apnea that delivers pressurized air through a mask that can lower triglyceride and improve HDL levels.

Long-term, severe sleep apnea also may put children at higher risk for pulmonary hypertension, when pressure in the blood vessels from the heart to the lungs is too high. The statement committee recommends that future research on how sleep apnea affects children's risk for heart problems incorporates 24-hour blood pressure monitoring and measures of metabolic syndrome factors.

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