Related Experiment Videos
Nasal resistances are useful in identifying children with severe obstructive sleep apnea before polysomnography
Maurizio Rizzi1, Josè Onorato, Arnaldo Andreoli
1Servizio Fisiopatologia Respiratoria, Università di Milano, Ospedale Luigi Sacco Azienda Ospedaliera, Polo Universitario, Via G.B. Grassi 74, Italy.
Insights
Anterior rhinometry, measuring nasal resistance, effectively identifies severe obstructive sleep apnea (OSA) in children with adenotonsillar hypertrophy. This simple test aids in diagnosing sleep-disordered breathing in this pediatric population.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Otorhinolaryngology
Background:
- Adenotonsillar hypertrophy is a common cause of sleep-disordered breathing in children.
- Obstructive sleep apnea (OSA) significantly impacts children's health and development.
- Accurate and accessible diagnostic tools for pediatric OSA are crucial.
Purpose of the Study:
- To evaluate anterior rhinometry as a simple and effective method for identifying severe OSA.
- To assess the correlation between nasal resistance and OSA severity in children with adenotonsillar hypertrophy.
- To determine the diagnostic accuracy of nasal resistance for OSA in this population.
Main Methods:
- Seventy-three children with adenotonsillar hypertrophy and suspected sleep-disordered breathing were studied.
- Data collected included parental questionnaires, clinical examinations, polysomnography, and anterior rhinometry.
- Nasal patency was measured using anterior rhinometry.
Main Results:
- Obstructive sleep apnea (OSA) was diagnosed in 60% of the children.
- Total nasal resistance significantly correlated with OSA severity indicators like apnea-hypopnea index and oxygen desaturation.
- A nasal resistance value of 0.59 Pa/cm³/s demonstrated high sensitivity (91%) and specificity (96%) for identifying OSA.
Conclusions:
- Nasal resistance measured by anterior rhinometry is a significant risk factor for OSA in children with adenotonsillar hypertrophy.
- Anterior rhinometry is a valuable and practical tool for routine evaluation of sleep-disordered breathing in these children.
Objective:
In this study, we would like to show that anterior rhinometry measurement of nasal resistance would be a simple and useful test to identify severe obstructive sleep apnea (OSA) in a population of children affected by adenotonsillar hypertrophy.
Methods:
Seventy-three consecutive children (44 males; mean age 5.4+/-1.2 years) with adenotonsillar hypertrophy, who complained sleep-disordered breathing, were studied. All the parents completed a questionnaire concerning the children's sleeping habits and sleep complaints before consultation; each child underwent a general paediatric examination and an evaluation of craniofacial features and upper airway patency. In all 73 children polysomnography was performed and anterior rhinometry nasal patency was measured.
Results:
The diagnosis of OSA was confirmed in 44/73 patients (60%). Total nasal resistance showed a significant direct correlation with apnea hypopnea index, arousal index, snoring time, percentage of sleep time spent at SaO(2)<90% and a significant inverse correlation with total sleep time, sleep efficiency and the mean of SaO(2)% during sleep. Total nasal resistance was significantly related to snoring, mouth breathing and daytime sleepiness. The receiver operator characteristics (ROC) curve indicates that in the range of age of our sample a nasal resistance value of 0.59 Pa/cm(3)/s has a sensitivity of 91% and specificity of 96% for identifying the children with adenotonsillar hypertrophy affected by OSA.
Conclusions:
Our study shows that in children with adenotonsillar hypertrophy nasal resistance seems to be risk factor for OSA. The anterior rhinometry appears as a useful tool in routine evaluation of sleep-disordered breathing in these patients.