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Reference values for nocturnal home polysomnography in primary schoolchildren
Dorothee Moss1, Michael S Urschitz, Anette von Bodman
1Department of Neonatology, University Children's Hospital Tuebingen, 72076 Tuebingen, Germany.
Insights
Abbreviated home polysomnography offers a potential alternative for pediatric sleep studies. This research provides crucial reference values for respiratory events and movements in children, aiding in accurate diagnosis.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
- Diagnostic Tools in Children
Background:
- Abbreviated home polysomnography (HPS) is a potential alternative to laboratory polysomnography for pediatric sleep assessment.
- Lack of established reference values for respiratory events using nasal prongs hinders widespread acceptance of HPS.
- Normative data are needed to interpret HPS results accurately in children.
Purpose of the Study:
- To determine the prevalence and frequency of central, obstructive, and mixed apneas and hypopneas in children using abbreviated HPS with nasal prongs.
- To establish normative data for respiratory events, movements/arousals, and body position changes in a pediatric population.
- To provide reference values that can aid in the clinical interpretation of abbreviated HPS in school-aged children.
Main Methods:
- A population-based sample of 50 children (mean age 10.1 years) underwent abbreviated home polysomnography using nasal prongs.
- Data collected included central, obstructive, and mixed apneas, hypopneas, movements/arousals, and body position changes.
- Statistical analysis determined the average frequency and established cutoff values (mean + 2 SD or 95th percentile) for each sleep variable.
Main Results:
- All children exhibited central apneas, with an average frequency of 1.5 events per hour.
- Obstructive apneas (36%), mixed apneas (6%), and hypopneas (14%) were observed in a subset of children.
- Average hourly frequencies were 0.1 obstructive apneas, 0.01 mixed apneas, and 0.02 hypopneas, with established cutoff values provided.
- Movement/arousals averaged 8.2 per hour and body position changes 3.7 per hour, with corresponding cutoff values.
Conclusions:
- This study presents the first reference values for respiratory events and sleep variables obtained via abbreviated home polysomnography with nasal prongs in children.
- The established normative data can significantly improve the interpretation of abbreviated HPS results in clinical and research settings.
- Abbreviated HPS with nasal prongs shows promise as a diagnostic tool, supported by these new reference values for pediatric sleep assessment.
Abstract:
Abbreviated home polysomnography may be an alternative to laboratory polysomnography in children but is not yet generally accepted, partly due to a lack of reference values. Also, there are no normative data on respiratory events obtained using nasal prongs. We determined the prevalence and frequency of central, obstructive, and mixed apneas and hypopneas in a population-based sample of 50 children (mean age 10.1 years) using abbreviated home polysomnography and nasal prongs. We also determined the frequency of movements/arousals and body position changes. All children had central apneas. Obstructive apneas, mixed apneas, and hypopneas were found in 36%, 6%, and 14% of children, respectively. Average number of central, obstructive, and mixed apneas; hypopneas; movement/arousals; and body position changes per hour of sleep was 1.5, 0.1, 0.01, 0.02, 8.2, and 3.7, respectively. The corresponding cutoff values (mean plus 2 standard deviations or 95th centile) were 3.7, 0.7, 0.1, 0.2, 13.4, and 9.1, respectively. We did not find significant gender differences regarding any sleep variable under study. The presented reference values may help clinicians and researchers to improve the interpretation of abbreviated home polysomnography in school-age children.
