严重肥胖的14岁男孩在头部创伤几年后患有中央睡眠呼吸暂停症
Yusuke Moritani1, Takumi Shibazaki1, Hotaru Kobori1
1Department of Pediatrics, Shinshu University School of Medicine, Nagano, Japan.
概括
中央睡眠呼吸暂停 (CSA) 在儿童中不常见,但在肥胖的年轻人中更为频繁. 这一案例强调严重肥胖是青少年中CSA的原因,即使有先前的神经损伤.
科学领域:
- 儿科肺病学 儿科肺病学
- 睡眠医学 睡眠医学
- 神经学 神经学
背景情况:
- 中央睡眠呼吸暂停 (CSA) 在儿科患者中很少见.
- 虽然经常与神经疾病,如奇阿里形有关,但CSA的患病率在肥胖儿童中显著增加.
- 肥胖通常与阻塞性睡眠呼吸暂停有关,但其在CSA中的作用需要进一步了解.
研究的目的:
- 报告小儿病人的中部睡眠呼吸暂停 (CSA) 病例,这是严重肥胖的次要原因.
- 调查肥胖可以诱导青少年CSA的潜在机制.
- 强调需要对严重肥胖儿童进行CSA监测.
主要方法:
- 一个14岁的男性患有严重肥胖和睡眠呼吸暂停症状的案例介绍.
- 多睡眠学测量睡眠呼吸暂停的严重程度,包括呼吸暂停-呼吸暂停指数 (AHI) 和中央呼吸暂停指数 (CAI).
- 大脑的磁共振成像 (MRI) 评估神经系统异常,特别是脑干和小脑变化.
主要成果:
- 多睡眠学表明严重的睡眠呼吸暂停综合征 (AHI = 41.4 /小时) 与显著的中央呼吸暂停指数 (CAI = 8.9 /小时).
- 头骨MRI显示了小脑梗塞的持续旧变化,但没有急性心脏病发作.
- 患者的呼吸中心功能可能受到先前头部损伤的影响,被认为是稳定的,这意味着肥胖是首要的CSA驱动因素.
结论:
- 严重的肥胖症可以导致儿童的中央睡眠呼吸暂停 (CSA),可能是通过诸如喉崩和胸部体积减少等机制影响呼吸驱动.
- 这一案例强调,肥胖,而不仅仅是神经缺陷,应该被认为是儿童患者中CSA的重要原因.
- 对于严重肥胖的儿童,建议对CSA进行常规监测.
相关概念视频
Sleep Apnea
149
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
149
Acute Respiratory Failure-IV
154
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
154
Sleep-Wake Cycles
1.3K
Sleep is an essential physiological process vital to maintaining overall well-being. The reticular activating system (RAS), a network of neurons in the brainstem, regulates wakefulness and sleep. While it may seem passive, sleep consists of distinct cycles, each with its unique characteristics and functions. Two key sleep phases are non-rapid eye movement (NREM) and rapid eye movement (REM).
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
NREM Sleep
NREM sleep comprises four progressive stages that seamlessly merge:
1.3K
Sleepwalking and Sleep Talking
158
Somnambulism, commonly known as sleepwalking, involves individuals engaging in activities ranging from simple walking to more complex behaviors such as driving. Sleepwalking typically occurs during the slow-wave sleep stages 3 and 4 early in the night when the person is not dreaming, contradicting the myth that sleepwalkers are acting out their dreams.
Factors that increase the likelihood of sleepwalking include sleep deprivation and alcohol consumption. Contrary to common beliefs, it is safe...
Factors that increase the likelihood of sleepwalking include sleep deprivation and alcohol consumption. Contrary to common beliefs, it is safe...
158
Narcolepsy
102
Narcolepsy is a chronic sleep disorder characterized by pervasive, uncontrolled sleepiness and other sleep disturbances. One of its hallmark symptoms is an abrupt transition to REM sleep upon falling asleep, which causes symptoms typically associated with this phase to occur unexpectedly during wakefulness. These include the following symptoms, which typically last from a minute or two to half an hour.
102


