Polysomnographic findings of obstructive sleep apnea in children with adenotonsillar hypertrophy
- 1 Ophtalmology, Otorhinolaryngology and Head & Neck Surgery Department, Botucatu School of Medicine, S?o Paulo State University, Botucatu, Brazil
- 2 Ophtalmology, Otorhinolaryngology and Head & Neck Surgery Department, Botucatu School of Medicine, S?o Paulo State University, Botucatu, Brazil
- 3 Neurology, Neuro Clinics, Botucatu, Brazil
- 4 Ophtalmology, Otorhinolaryngology and Head & Neck Surgery Department, Botucatu School of Medicine, S?o Paulo State University, Botucatu, Brazil
Abstract
Serous Background: There are few studies assessing the clinical manifestations of sleep breathing disorders and polysomnograms in several pediatric age ranges. This studied aimed to assess polysomnography results such as apnea-hypopnea index, mean oxygen saturation and sleep efficiency in children presenting with airway obstruction and adenotonsillar hypertrophy complaints, and to establish whether they are correlated to age and sex. Methods: A retrospective study with children of both sexes, aged between 2 and 12 years, with clinically suspected obstructive sleep apnea syndrome and adenotonsillar hypertrophy, who underwent polysomnography before surgery. The children were allocated to groups according to their age range (Group I: 2 to 4 years old; Group II: 5 to 8 years old; Group III: 9 to 12 years old). Apnea-hypopnea index, mean oxygen saturation and sleep efficiency data were compared between sexes and among the three groups (Student’s t test, p < 0.05). Results: Of 167 children studied by polysomnography, 76.6% were of school age and 67% were male. For all studied age ranges, there was no difference between sexes for the investigated parameters (body mass index, apnea-hypopnea index, mean oxygen saturation and sleep efficiency). As regards mean oxygen saturation, Group I showed the lowest value (89.9 ± 6.2). Apnea-hypopnea indexes were higher in male children aged between 2 and 4 years (9.9 ± 5.2). Group III had the lowest sleep efficiency (84.1 ± 9.2). Conclusion: There was a predilection of more severe cases of obstructive sleep apnea syndrome for children younger than four years, shown by higher apnea-hypopnea index per hour and lower mean oxygen saturation in this age range.
- Guilleminault, C., Eldridge, F.L., Simmons, F.B. and Dement, W.C. (1976) Sleep apnea in eight children. Pediatrics, 58, 23-30.
- American Thoracic Society (1996) Standards and indications for cardiopulmonary sleep studies in children. American Journal of Respiratory and Critical Care Medicine, 153, 866-878. doi:10.1164/ajrccm.153.2.8564147
- Brunetti, L., Rana, S., Lospalluti, M.L., Pietrafesa, A., Francavilla, R., Fanelli, M., et al. (2001) Prevalence of obstructive sleep apnea in a cohort of 1207 children of Southern Italy. Chest, 120, 1930-1935. doi:10.1378/chest.120.6.1930
- Anuntaseree, W., Rookkapan, K., Kuasirikul, S. and Thingsuksai, P. (2001) Snoring and obstructive sleep apnea in Thai school-age children: Prevalence and predisposing factors. Pediatric Pulmonology, 32, 322-327. doi:10.1002/ppul.1112
- Gislason, T. and Benediktsdóttir, B. (1995) Snoring, apneic episodes, and nocturnal hypoxemia among children 6 months to 6 years old. Chest, 107, 963-966. doi:10.1378/chest.107.4.963
- Bower, C. and Buckmiller, L. (2001) What’s new in pediatric obstructive sleep apnea. Current Opinion in Otolaryngology & Head and Neck Surgery, 9, 352-358. doi:10.1097/00020840-200112000-00003
- Anstead, M. (2000) Pediatric sleep disorders: New developments and evolving understanding. Current Opinion in Pulmonary Medicine, 6, 501-506. doi:10.1097/00063198-200011000-00007
- Masood, A. and Phillips, B. (2000) Sleep apnea. Current Opinion in Pulmonary Medicine, 6, 479-484. doi:10.1097/00063198-200011000-00003
- Sack, R.L., Auckley, D., Auger, R.R., et al. (2007) Circadian rhythm sleep disorders: Part II, advanced sleep phase disorder, delayed sleep phase disorder, free-running disorder, and irregular sleep-wake rhythm. An American Academy of Sleep Medicine review. Sleep, 30, 1484-1501.
- Cinar, U., Vural, C., Cakir, B., Topuz, E., Karaman, M.I. and Turgut, S. (2001) Nocturnal enuresis and upper-airway obstruction. International Journal of Pediatric Otorhinolaryngology, 59, 115-118. doi:10.1016/S0165-5876(01)00463-3
- Weber, S.A.T., Santos, V.J.B., Semenzati, G.O. and Martim, L.C. (2012) Ambulatory blood pressure monitoring in children with obstructive sleep apnea and primary snoring. International Journal of Pediatric Otorhinolaryngology, 76, 787-790. doi:10.1016/j.ijporl.2012.02.041
- Katz, E.S., Greene, M.G., Carson, K.A., Galster, P., Loughlin, G.M., Carroll, L., et al. (2001) Night-to-night variability of polysomnography in children with suspected obstructive sleep apnea. Journal of Pediatrics, 140, 589-594. doi:10.1067/mpd.2002.123290