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Open AccessArticle

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

1
Department of Pulmonology, Multidisciplinary Sleep Unit, Sant Joan d′Alacant University Hospital, Ctra Alacant-València s/n, 03550 Sant Joan d′Alacant, Spain
2
Department of Pulmonology, Multidisciplinary Sleep Unit, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
3
Respiratory Diseases Networking Biomedical Research Center (CIBER), Carlos III Health Institute, 28029 Madrid, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2067; https://doi.org/10.3390/jcm9072067
Received: 11 May 2020 / Revised: 21 June 2020 / Accepted: 29 June 2020 / Published: 1 July 2020
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. View Full-Text
Keywords: sleep apnea; child; polysomnography; diagnosis; therapy; decision making sleep apnea; child; polysomnography; diagnosis; therapy; decision making
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Chiner, E.; Cánovas, C.; Molina, V.; Sancho-Chust, J.N.; Vañes, S.; Pastor, E.; Martinez-Garcia, M.A. Home Respiratory Polygraphy is Useful in the Diagnosis of Childhood Obstructive Sleep Apnea Syndrome. J. Clin. Med. 2020, 9, 2067.

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