Home Respiratory Polygraphy is Useful in the Diagnosis of Childhood Obstructive Sleep Apnea Syndrome

Abstract

<jats:p>The utility of home respiratory polygraphy (HRP) was assessed as an alternative to polysomnography (PSG) in the diagnosis of childhood obstructive sleep apnea syndrome (OSAS). PSG was indicated only in patients with concomitant disease or where HRP results were questionable. The follow-up period was 1 year. We recorded clinical and anthropometric data, physical examination findings, respiratory variables, severity level and choice of therapy. We assessed 121 children, 70 boys and 51 girls, with mean age 7 ± 4 years, mean body mass index (BMI) 19 ± 5 kg/m2, and mean BMI percentile 62 ± 38%. We included 104 HRP and 24 PSG recordings. Of the latter, 7 were preceded by HRP (false negatives) and 17 were indicated as the first-choice method owing to concomitant disease. Of the initial HRP recordings, 93% were technically valid. All technically valid HRPs and 96% of PSGs resulted in a diagnosis of OSAS (apnea-hypopnea index 9.5 ± 9.1/h). Thirty-three percent of cases were moderate and 22% severe. Apnea-hypopnea index showed no correlation with BMI or BMI percentile. Adenotonsillectomy was indicated in 93 patients (77%), conservative treatment in 17 (14%), and conservative treatment combined with CPAP/BiPAP in 11 (9%). There were no significant differences between children diagnosed by HRP and by PSG in terms of treatment choice. The prevalence of OSAS in our sample was 96.7%. In conclusion, when the probability of OSAS is high, HRP is usually sufficient for diagnosing the syndrome and establishing therapy in children. PSG is advisable in complex or questionable cases.</jats:p>

Bispectral Analysis of Heart Rate Variability to Characterize and Help Diagnose Pediatric Sleep Apnea

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Telemedicine-based sleep services for a complex child: optimizing care during a pandemic and beyond

“…9 By providing more accessible sleep consultation and testing for this population through telehealth, pediatric sleep health practitioners can support the already tremendous efforts of multidisciplinary teams caring for patients with autism spectrum disorder. 4 The successful initial use of HSAT in this patient, another adaptation put in place due to the pandemic, highlights its utility as a feasible alternative to polysomnography, [3][4][5] particularly in children with atypical neurodevelopment who already struggle with sleep. [9][10][11] The failed postoperative HSAT demonstrates the difficulties with utilizing this technology in children.…”

“…2 However, studies that followed the publication of this guideline demonstrated minimal artifact and good sensitivity and specificity when evaluating moderate/severe sleep-disordered breathing, 3 particularly in older children. 4,5 More research is needed to explore this technology in children.…”

Periprocedural Management during Therapeutic Cardiac Catheterization in Patients with Sleep Apnea Syndrome: Report of Three Cases and Review of Literature

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