Ioan Iulia, Weick Diane, Schweitzer Cyril, Guyon Aurore, Coutier Laurianne, Franco Patricia
Service d'Explorations Fonctionnelles Pédiatriques, Hôpital d'Enfants, Centre Hospitalier Universitaire de Nancy, Nancy, France.
Faculté de Médecine, Université de Lorraine, Nancy, France.
J Clin Sleep Med. 2020 Jul 15;16(7):1013-1019. doi: 10.5664/jcsm.8372.
Due to a limited number of pediatric sleep centers, the aim was to test the feasibility of ambulatory polysomnography (PSG-home) in a group of French children suspected of OSA.
Children undergoing one-night PSG-home, with the device installed at the pediatric sleep physician's office, were prospectively included. General failure was considered when PSG-home recording captured < 5 h of artifact-free sleep or when ≥ 1 channel (nasal flow, thoraco-abdominal belts, oximetry) presented artifacts > 75% of the recording time. No-OSA was defined as an obstructive apnea-hypopnia index (OAHI) < 1 event/h and respiratory-related arousals index (RAI) < 1 event/h. OSA was defined as upper airways resistance syndrome (UARS) with OAHI < 1 event/h with RAI ≥ 1 event/h, or mild OSA (OAHI ≥ 1 event/h-5 events/h), moderate OSA (OAHI ≥ 5 events/h-10 events/h), or severe OSA (OAHI ≥ 10 events/h). Parents completed a severity hierarchy score questionnaire, Conners Parent Rating Scale, and an adapted Epworth Sleepiness Scale.
Fifty-seven children aged 3 through 16 years were included. PSG-home was technically acceptable in 46 (81%). Failure due to nasal cannula was observed in 11% (n = 6), oximetry in 7% (n = 4), and both in 2% (n = 1) of cases. No difference in feasibility was found according to age, sex, OSA severity, or comorbidities. There were 14 (25%) children categorized as no-OSA, 43 (75%) as OSA, 4 (7%) as UARS, 26 (46%) as mild, 6 (10%) as moderate, and 7 (12%) as severe OSA. Neither questionnaires nor clinical and physical examination predicted OSA diagnosis.
When equipment is installed at the professional's office and a parent monitors the child, PSG-home is feasible and technically acceptable in children aged 3 through 16 years old. The short delay and feasibility provided by PSG-home could improve the management of children suspected of OSA.
由于儿科睡眠中心数量有限，本研究旨在测试动态多导睡眠图（家庭版多导睡眠图，PSG-home）在一组疑似阻塞性睡眠呼吸暂停（OSA）的法国儿童中的可行性。
前瞻性纳入在儿科睡眠医生办公室安装设备并接受一晚家庭版多导睡眠图检查的儿童。当家庭版多导睡眠图记录的无伪差睡眠时长小于5小时，或当≥1个通道（鼻气流、胸腹带、血氧饱和度）的伪差出现时间占记录时间的75%以上时，视为总体失败。非OSA定义为阻塞性呼吸暂停低通气指数（OAHI）<1次/小时且呼吸相关觉醒指数（RAI）<1次/小时。OSA定义为上气道阻力综合征（UARS），OAHI<1次/小时且RAI≥1次/小时，或轻度OSA（OAHI≥1次/小时 - 5次/小时）、中度OSA（OAHI≥5次/小时 - 10次/小时）或重度OSA（OAHI≥10次/小时）。家长完成一份严重程度分级评分问卷、康纳斯父母评定量表和一份改编的爱泼华嗜睡量表。
纳入了57名3至16岁的儿童。46名（81%）儿童的家庭版多导睡眠图在技术上是可接受的。11%（n = 6）的病例因鼻导管出现失败，7%（n = 4）因血氧饱和度监测出现失败，2%（n = 1）的病例两者均出现失败。根据年龄、性别、OSA严重程度或合并症，在可行性方面未发现差异。有14名（25%）儿童被归类为非OSA，43名（75%）为OSA，4名（7%）为UARS，26名（46%）为轻度，6名（10%）为中度，7名（12%）为重度OSA。问卷以及临床和体格检查均不能预测OSA诊断。
当设备安装在专业人员办公室且由家长监护孩子时，家庭版多导睡眠图在3至16岁儿童中是可行的且在技术上是可接受的。家庭版多导睡眠图提供的短时间延迟和可行性可改善对疑似OSA儿童的管理。
