Coutier L, Bierme P, Thieux M, Guyon A, Ioan I, Reix P, Franco P
Service de pneumologie infantile, allergologie et centre de référence en mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France; Service d'épileptologie clinique, des troubles du sommeil et de neurologie fonctionnelle de l'enfant, Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France; INSERM, U1028, CNRS, UMR5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France.
Service de pneumologie infantile, allergologie et centre de référence en mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.
Sleep Med. 2020 Aug;72:59-64. doi: 10.1016/j.sleep.2020.03.003. Epub 2020 Mar 14.
OBJECTIVE/BACKGROUND: Currently, obstructive sleep apnea syndrome (OSAS) management in Robin sequence (RS) infants has not been standardized. Sleep laboratory polysomnography (PSG) is the gold standard for OSAS diagnosis, however, access is restricted. This study aimed to compare the respiratory indexes measured in a sleep laboratory using PSG as well as a possible alternative, polygraphy (PG).
PATIENTS/METHODS: This retrospective study was conducted between 2015 and 2017 in a tertiary hospital. PSG performed in RS infants in the sleep laboratory was analysed by a single reviewer. After sleep data removal, anonymized raw data were analysed to obtain only PG data. Respiratory indexes were compared for (i) PSG and PG and (ii) patients with or without OSAS clinical signs.
Among the 20 RS (median [IQR] age: 43 [25-114] days at evaluation), 70% of the patients had OSAS clinical signs but all of them had severe OSAS. The median mixed obstructive apnea hypopnea index was not significantly different between PSG and PG (27/h [18-38] versus 26/h [18-56], p = 0.43). The median obstructive apnea index was higher with no significant difference between PG and PSG (19/h [15-31] versus 7/h [4-25], p = 0.05). The median obstructive hypopnea index was significantly lower on PG than on PSG (2/h [0-3] versus 8/h [8-19], p = 0.01). No difference on PSG or PG was observed for patients with and without clinical signs of OSAS.
Although PSG remains the gold standard for OSA evaluation, a PG seems to be a useful alternative to measure OSA in RS infants because of their OSAS severity. This evaluation should be recommended in all RS infants, even in the absence of OSAS clinical signs.
Not applicable.
目的/背景：目前，罗宾序列征（RS）婴儿阻塞性睡眠呼吸暂停综合征（OSAS）的管理尚未标准化。睡眠实验室多导睡眠图（PSG）是OSAS诊断的金标准，然而，其应用受限。本研究旨在比较在睡眠实验室使用PSG以及一种可能的替代方法——多通道睡眠图（PG）所测量的呼吸指标。
患者/方法：本回顾性研究于2015年至2017年在一家三级医院进行。睡眠实验室中对RS婴儿进行的PSG由一名审阅者进行分析。去除睡眠数据后，对匿名的原始数据进行分析以仅获取PG数据。比较（i）PSG和PG以及（ii）有或无OSAS临床体征患者的呼吸指标。
在20例RS患者中（评估时的中位[四分位间距]年龄：43[25 - 114]天），70%的患者有OSAS临床体征，但所有患者均患有重度OSAS。PSG和PG之间的中位混合性阻塞性呼吸暂停低通气指数无显著差异（27次/小时[18 - 38]对26次/小时[18 - 56]，p = 0.43）。PG的中位阻塞性呼吸暂停指数较高，PG和PSG之间无显著差异（19次/小时[15 - 31]对7次/小时[4 - 25]，p = 0.05）。PG的中位阻塞性低通气指数显著低于PSG（2次/小时[0 - 3]对8次/小时[8 - 19]，p = 0.01）。有和无OSAS临床体征的患者在PSG或PG上均未观察到差异。
尽管PSG仍然是OSA评估的金标准，但由于RS婴儿的OSAS严重程度，PG似乎是测量RS婴儿OSA的一种有用替代方法。即使在没有OSAS临床体征的情况下，也应建议对所有RS婴儿进行这种评估。
不适用。
