Division of Pediatric Pulmonology, Marmara University, School of Medicine, Istanbul, Turkey.
Sleep Center, Marmara University, School of Medicine, Istanbul, Turkey.
Pediatr Pulmonol. 2023 Jul;58(7):1875-1881. doi: 10.1002/ppul.26404. Epub 2023 Apr 4.
Polygraphy (PG) can be used as an alternative test for the diagnosis of obstructive sleep apnea syndrome (OSAS) in children. Night-to-night variability of PG in children is not known. Our aim was to determine whether a single night PG was reliable for OSAS diagnosis in children with symptoms of sleep-disordered breathing (SDB).
Otherwise healthy children who had been evaluated for symptoms of SDB were included. Two nocturnal PGs were performed 2-7 days apart. Demographic and clinical characteristics, Pediatric Sleep Questionnaire, and modified Epworth Sleepiness Scale were recorded. OSAS was diagnosed if obstructive apnea-hypopnea index was (oAHI) ⩾ 1/h and classified as mild (oAHI: 1-4.9/h), moderate (oAHI: 5-9.9/h), and severe (oAHI ⩾ 10/h).
Forty-eight patients were included (37.5% female, age 10.8 ± 3.9 years) to the study. There were no significant differences in oAHI values and other respiratory parameters between the two PGs (p > 0.05). Thirty-nine children were diagnosed with OSAS if the highest oAHI over any single night was used for diagnosis. Thirty-three of the 39 children (84.6%) were diagnosed with OSAS with the first PG while 35 of 39 (89.7%) children were diagnosed with OSAS with the second PG. There was an agreement for identifying OSAS and its severity between the two PGs in our study even though there were few individual intra-subject differences in oAHI.
There was no significant first-night effect for PG in this study which suggests that a single night PG is adequate for diagnosis of OSAS in children with SDB- related symptoms.
测谎仪(PG)可作为儿童阻塞性睡眠呼吸暂停综合征(OSAS)诊断的替代测试。目前尚不清楚儿童 PG 的夜间变异性。我们的目的是确定在有睡眠呼吸障碍(SDB)症状的儿童中,单夜 PG 是否可用于 OSAS 诊断。
本研究纳入了经评估有 SDB 症状的健康儿童。在 2-7 天内进行两次夜间 PG。记录人口统计学和临床特征、儿童睡眠问卷和改良 Epworth 嗜睡量表。如果阻塞性呼吸暂停低通气指数(oAHI)≥1/h,则诊断为 OSAS,并分为轻度(oAHI:1-4.9/h)、中度(oAHI:5-9.9/h)和重度(oAHI≥10/h)。
共有 48 名患者(37.5%女性,年龄 10.8±3.9 岁)纳入研究。两次 PG 之间 oAHI 值和其他呼吸参数无显著差异(p>0.05)。如果使用任何单夜的最高 oAHI 值进行诊断,有 39 名儿童被诊断为 OSAS。39 名儿童中有 33 名(84.6%)首次 PG 被诊断为 OSAS,39 名儿童中有 35 名(89.7%)第二次 PG 被诊断为 OSAS。即使 oAHI 个体内差异较小,两次 PG 之间在识别 OSAS 及其严重程度方面仍存在一致性。
本研究中 PG 无明显的首夜效应,这表明单夜 PG 足以诊断有 SDB 相关症状的儿童的 OSAS。