Abstract
Objectives:
Sleep-disordered breathing (SDB) affects approximately 12% of children, ranging from snoring to obstructive sleep apnea (OSA). Polysomnography (PSG) is the gold standard for diagnosing SDB and has been increasingly obtained in children. Some feel PSG is underutilized given recent clinical guidelines; however, others believe that if the clinical indicators for OSA are present, a PSG is unnecessary. The purpose of this study was to determine the effectiveness of clinical indicators in predicting PSG results in children.
Methods:
A retrospective review of PSG on children between 2 and 18 years old ordered by an otolaryngologist at West Virginia University between January 2011 and November 2013. Recorded variables included: age, sex, symptoms of gasping, snoring, restlessness, body mass index, previous adenoidectomy, tonsil size, and apnea-hypopnea index (AHI). Statistical analysis was used to compare positive PSG with clinical indicators.
Results:
Ninety-five patients were reviewed with 73 meeting inclusion criteria. Age range was 2 to 17 years (mean, 5.3 years) and mean AHI was 3.26. Gasping showed a statistical significant correlation with positive PSG (61.9% positive, P < .05). Overweight/obese patients with gasping had a 73.3% positive PSG. Snoring and restlessness did not have a statistically significant correlation with positive PSG; however, restlessness was approaching clinical significance. One patient (25%) without gasping and restlessness combined had positive PSG. Gasping had a statically significant higher mean AHI of 4.3 compared to 2.2 without symptoms of gasping. Neither snoring nor restlessness showed statistically significant higher AHI.
Conclusions:
Gasping is an effective clinical indicator in predicting positive PSG and diagnosing OSA in children.
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