The Characteristics And Clinical Significance Of REM<10% In Children With Sleep-disordered Breathing

Objectives1.To investigate the use of little REM sleep and REM<10% in describing the characteristics of children with sleep-disordered breathing and the clinical significance,discuss whether indicator is more persuasive.2.To propos the“little REM sleep”for children.MethodsA retrospective analysis was made on 616 pediatric patients with sleep-disordered breathing.According to the proportion of REM phase among the total sleep time and studying further,1.they were divided into two groups:REM<20% group and REM?20% group,and an inter-group comparative analysis was made in terms of the patient's age,sex,BMI,sleep efficiency,number of wakeups,sleep latency,AHI,OAI and LSpO2.2.The children in the REM<20%group were further divided into REM<10% group,10%?REM<15% group and15%?REM<20% group;an inter-group comparison was made in terms of the aforementioned parameters among the four groups(including the REM?20% group).3.An analysis of correlation was made between the REM sleep percentage of the children in the REM<20% group and in the REM < 10% group and AHI,OAI,LSpO2,sleep efficiency and number of wake-ups.4.A logistic regression analysis was made on the children with a REM<10%,including single factor and multi-factor analysis of variance.5.A retrospective analysis was made on 119 male pediatiric patients with SDB,Conducted a survey of child behavior problems meanwhile,aged between 6 to 11 years old,and they were divided into REM<10% group and REM? 10% group.The differences of 9 factors,such as depression,schizophrenia,compulsion,bad communication,social withdrawal,physical appeal,aggression,hyperactivity and discipline,were analyzed in the two groups.Results1.The comparison between REM<20% group and REM?20% group indicated that,the former group had a higher waking times than the latter group,and the former had a low sleep efficiency than the latter group.(P value was <0.001 and0.001 respectively),and the comparison in other parameters exhibited no statistical difference.2.As for the intergroup comparison among REM<10% group,10%?REM<15% group,15%?REM<20% group and REM?20% group,The REM<10% group,10%?REM<15% group and 15%?REM<20% group had a low sleep efficiency than the REM?20% group significantly(P value was0.009,0.022 and<0.001,respectively),the children in REM<10% group,10%?REM<15% group and15%?REM<20% group had a higher number of wake-ups than those in the REM?20% significantly(P value was less than 0.001),the children in the REM<10% group had a higher AHI than those in the REM?20% group significantly(P value was 0.025),and the REM<10% group had a lower LSpO2 than the REM?20% group significantly(P=0.019)and the comparison in the remaining parameters exhibited no statistical difference.3.As all of the data were nonnormally distributed,the spearman correlation analysis found that,the REM sleep percentage in the REM<10% group was negatively correlated with AHI(r=-0.216,P=0.031),positively correlated with LSpO2(r=0.2,p=0.046),and had no correlation with OAI,sleep efficiency and number of wake-ups(P value was 0.262,0.161 and 0.327).Likewise,the spearman correlation analysis found that,the REM sleep percentage of the children in the REM < 20% group had no correlation with AHI,OAI,LSpO2,sleep efficiency and number of wake-ups.4.The logistic regression analysis of REM<10% indicated that,there was a statistical difference between the single-factor and multi-factor analyses of variance in AHI(P=0.012,OR=1.016,95%CI[1.004,1.029]).5.The comparison between REM<10% group and REM?10% groupindicated that the schizophrenia and hyperactivity of REM<10% group are severer than that of REM?10% group(P value was0.022 and 0.036,respectively),the comparison in other parameters exhibited no statistical difference.ConclusionREM<10% is more persuasive in evaluating the characteristics and clinical significance of children with sleep-disordered breathing,AHI is a risk factor for the occurrence of REM<10%.Behavioral problem of children with REM<10% have a tendency to aggravate,and REM<10% is a more suitable indicator to represent the pediatric “little REM sleep”.