Nosetti Luana, Zaffanello Marco, Simoncini Daniela, Dellea Gaia, Vitali Maddalena, Amoudi Hajar, Agosti Massimo
Pediatric Sleep Disorders Center, Division of Pediatrics, "F. Del Ponte" Hospital, University of Insubria, 21100 Varese, Italy.
Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37100 Verona, Italy.
Children (Basel). 2024 Oct 10;11(10):1228. doi: 10.3390/children11101228.
BACKGROUND/OBJECTIVES: Obstructive Sleep Apnoea Syndrome (OSA) in children disrupts normal breathing patterns and sleep architecture, potentially leading to severe consequences. Early identification and intervention are crucial to prevent these issues. This study explored the relationships between waiting times for polysomnography (PSG), clinical history, patient age at the time of PSG, and PSG outcomes in children.
Two hundred and fourteen children were prospectively enrolled. Data were extracted from medical records regarding the patients' age at the time of a referral for PSG and their age at the time of its execution. Information on the waiting times for PSG, a diagnosis (primary snoring, mild, moderate, and severe OSA), and a history of snoring and apnoea were also collected. Additional data included medications, surgical interventions, passive smoke exposure, and allergies. The records also included the Paediatric Sleep Questionnaire (PSQ).
The patient age at the time of a PSG prescription was lower for patients with a short history of sleep apnoeas (≤12 months; 4.6 (SD 2.6) years) compared to those with a long history (>12 months; 5.5 (SD 2.7) years; = 0.027). The waiting time from prescription to PSG execution was shorter for patients with a short history of sleep apnoea (4.1 (SD 3.8) months) compared to those with a longer history (5.9 (SD 3.8) months; = 0.001). A higher frequency of having an adenotonsillectomies before a PSG prescription was observed in the long-history group compared to the short-history group (13.3% vs. 6.9%). Conversely, a higher frequency of adenoidectomies before a PSG prescription was noted in the short-history group compared to the long-history group (9.7% vs. 1.3%).
This study found that younger children with a shorter history of OSA are diagnosed and evaluated earlier than older children with a longer history of the condition, suggesting that prolonged symptoms may delay a diagnosis. ENT surgeries also vary among patients, with less invasive procedures (adenoidectomy) being more common in younger children with shorter histories of OSA. The increasing awareness of OSA highlights the need for improved access to diagnostic and treatment resources.
背景/目的：儿童阻塞性睡眠呼吸暂停综合征（OSA）会扰乱正常呼吸模式和睡眠结构，可能导致严重后果。早期识别和干预对于预防这些问题至关重要。本研究探讨了儿童多导睡眠图（PSG）检查的等待时间、临床病史、PSG检查时的患者年龄与PSG检查结果之间的关系。
前瞻性纳入214名儿童。从病历中提取有关患者PSG检查转诊时的年龄及其检查时的年龄的数据。还收集了PSG检查的等待时间、诊断结果（原发性打鼾、轻度、中度和重度OSA）以及打鼾和呼吸暂停病史的信息。其他数据包括用药情况、手术干预、被动吸烟暴露和过敏情况。病历中还包括儿童睡眠问卷（PSQ）。
与睡眠呼吸暂停病史较长（>12个月；5.5（标准差2.7）岁）的患者相比，睡眠呼吸暂停病史较短（≤12个月；4.6（标准差2.6）岁）的患者在开具PSG检查处方时年龄更小（P = 0.027）。与睡眠呼吸暂停病史较长的患者相比，睡眠呼吸暂停病史较短的患者从开具处方到进行PSG检查的等待时间更短（4.1（标准差3.8）个月对5.9（标准差3.8）个月；P = 0.001）。与短病史组相比，长病史组在开具PSG检查处方前进行腺样体扁桃体切除术的频率更高（13.3%对6.9%）。相反，与长病史组相比，短病史组在开具PSG检查处方前进行腺样体切除术的频率更高（9.7%对1.3%）。
本研究发现，与OSA病史较长的大龄儿童相比，OSA病史较短的年幼儿童更早得到诊断和评估，这表明症状持续时间延长可能会延迟诊断。耳鼻喉科手术在患者中也存在差异，侵入性较小的手术（腺样体切除术）在OSA病史较短的年幼儿童中更为常见。对OSA的认识不断提高，凸显了改善诊断和治疗资源获取途径的必要性。
