日本人閉塞性睡眠時無呼吸症候群児の臨床所見：歯科所見を中心に

Clinical findings in Japanese children with obstructive sleep apnea syndrome: focus on dental findings.

抄録

閉塞性睡眠時無呼吸症候群（OSA）児の歯科および口腔内を含む臨床所見について検討した。本研究では，耳鼻科医から精査入院を指示され，睡眠ポリグラフで無呼吸指数（AI）5以上を示したOSA小児27名を対象とした．彼らの臨床歴は母親から聴取し、口腔内所見も評価した。患者は男性15名（56％）、女性12名（44％）であった。平均体格指数（BMI）は16.0±3.0であった。睡眠と睡眠時間に関連する臨床所見のうち，いびきが最も高頻度に観察された（100％）．就寝時刻（午後9.2±0.8）と起床時刻（午前7.1±0.8）から算出した平均睡眠時間は、9.9±1.0時間であった。日中に得られた臨床所見のうち、鼻濁音が最も多く観察された（74％）。歯科では、口呼吸が最も高頻度に観察された（89％）。食事時間の平均は31.7±13.8分であった。口腔内検査の結果，ヘルマン歯齢はIIAが最も多かった．標準化された等級分類によると，I等級は7％，II等級は63％，III等級は30％の被験者に観察された．

We evaluated clinical findings including those on dentistry and in the oral cavity of children with obstructive sleep apnea syndrome (OSA). This study examined twenty-seven OSA children, who were advised by otolaryngologists to be admitted for closer examination and showed an apnea index (AI) of 5 or more on polysomnographs. Their clinical history was obtained from their mothers, and oral findings were also evaluated. The patient consisted of 15 males (56%) and 12 females (44%). The mean body mass index (BMI) was 16.0 +/- 3.0. Of the clinical findings related to sleeping and the duration of sleeping, snoring was the most frequently observed finding (100%). The mean duration of sleep, calculated from the time they went to bed (9.2 +/- 0.8 p.m.) and the time they got up (7.1 +/- 0.8 a.m.), was 9.9 +/- 1.0 hours. Of the clinical findings obtained during the daytime, hyponasal speech was the most frequently observed finding (74%). In terms of dentistry, oral breathing was the most frequently observed finding (89%). The mean duration of meals was 31.7 +/- 13.8 minutes. Results of oral examination revealed that Hellman's dental age was most frequently IIA. According to the standardized grading classification, grade I was observed in 7%, II in 63%, and grade III in 30% of subjects.