阻塞性睡眠呼吸暂停(OSA)
虽然增殖腺扁桃体切除术能使79%~92%儿童的阻塞性睡眠呼吸暂停得以缓解,但在肥胖儿童、患有唐氏综合征和潜在颅面畸形的儿童中有效率偏低。[77]Mitchell RB, Kelly J. Outcomes and quality of life following adenotonsillectomy for sleep-disordered breathing in children. ORL J Otorhinolaryngol Relat Spec. 2007;69:345-348.http://www.ncbi.nlm.nih.gov/pubmed/18033971?tool=bestpractice.com[78]Mitchell RB, Kelly J. Outcome of adenotonsillectomy for obstructive sleep apnea in obese and normal-weight children. Otolaryngol Head Neck Surg. 2007;137:43-48.http://www.ncbi.nlm.nih.gov/pubmed/17599563?tool=bestpractice.com[110]Costa DJ, Mitchell R. Adenotonsillectomy for obstructive sleep apnea in obese children: a meta-analysis. Otolaryngol Head Neck Surg. 2009;140:455-460.http://www.ncbi.nlm.nih.gov/pubmed/19328330?tool=bestpractice.com[111]Donaldson JD, Redmond WM. Surgical management of obstructive sleep apnea in children with Down syndrome. J Otolaryngol. 1988;17:398-403.http://www.ncbi.nlm.nih.gov/pubmed/2976430?tool=bestpractice.com有研究显示普通人群术后3年复发率为8.5%。[55]Contencin P, Guilleminault C, Manach Y. Long-term follow-up and mechanisms of obstructive sleep apnea (OSA) and related syndromes through infancy and childhood. Int J Pediatr Otorhinolaryngol. 2003;67(suppl 1):S119-S123.http://www.ncbi.nlm.nih.gov/pubmed/14662182?tool=bestpractice.com
儿童期行为失眠
据一项包括52个行为治疗研究的荟萃分析显示94%的调查对象表示行为干预有一定疗效,80%接受治疗的儿童持续3~6个月有效。[112]Mindell JA, Kuhn BR, Lewin DS, et al. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 2006;29:1263-1276. [Erratum in: Sleep. 2006;29:1380.]http://www.aasmnet.org/Resources/PracticeParameters/Review_NightWakingsChildren.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/17068979?tool=bestpractice.com
睡眠相位延迟综合征
对于不同治疗策略成功率的客观数据很少。寻求患者的合作是很极其重要的,如果没有患者的合作则几乎没有成功的几率。