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Are sleep studies worth doing?
V van Someren1, M Burmester, G Alusi
1Department of Paediatrics and Neonatology, Royal Free Hampstead NHS Trust, Pond Street, London NW3 2QG, UK. Vvs@btinternet.com
Insights
Pediatric sleep studies effectively assess sleep related upper airway obstruction (SRUAO) severity in children. Clinician assessments show good agreement with study findings, aiding treatment decisions.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Otolaryngology
Background:
- Sleep related upper airway obstruction (SRUAO) is a significant concern in children.
- Accurate diagnosis is crucial for appropriate management and to prevent complications.
Purpose of the Study:
- To evaluate the utility of a pediatric sleep study service for diagnosing SRUAO.
- To assess the correlation between clinical impressions and objective sleep study findings.
Main Methods:
- Prospective survey of 120 children (6 months to 15.5 years) with suspected SRUAO symptoms.
- Data collected included sleep study scores, referring clinician's impression, and parental symptom questionnaires.
- Analysis focused on SRUAO classification and agreement between clinical and study assessments.
Main Results:
- Sleep study scores classified children into normal (24), mild (42), moderate (33), and severe (21) SRUAO categories.
- Good agreement between clinician impression and study scores was observed in 71 out of 106 cases.
- No moderate or severe SRUAO cases were initially assessed as normal by clinicians; however, parental symptom scores did not strongly correlate with study findings.
Conclusions:
- Pediatric sleep studies are valuable for assessing SRUAO severity in children.
- These studies aid in determining the need for surgery, predicting postoperative respiratory failure risk, and serving as baseline/outcome measures.
- The findings support the integration of sleep studies into the management pathway for pediatric SRUAO.
Aims:
To evaluate a sleep study service for children suspected of having sleep related upper airway obstruction (SRUAO).
Design:
Prospective survey.
Setting:
Paediatric and ear, nose, and throat clinics of the Royal Free Hampstead NHS Trust.
Subjects:
Consecutively referred children with SRUAO symptoms.
Main Outcome Measures:
Sleep study data, referring clinician's impression, and completed symptom questionnaires.
Results:
A total of 120 children (aged 6 months to 15.5 years) were studied. Study scores showed that 24 were classified as normal, 42 as mild, 33 as moderate, and 21 as severe SRUAO. In the 106 cases with matching data between clinician's impression and study score, 71 had good agreement, 18 were underestimated by the clinician, and 17 were over estimated. No cases reported as moderate or severe sleep apnoea by the study were referred by the clinician as normal. There were no important associations between parental symptom scores and sleep study scores.
Conclusion:
In children with suspected SRUAO, sleep studies do contribute to assessing the need for operation, the likelihood of postoperative respiratory failure, or as a baseline or outcome measure in intervention studies.