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Polysomnographic characteristics in normal preschool and early school-aged children
Hawley E Montgomery-Downs1, Louise M O'Brien, Tanya E Gulliver
1Department of Psychology, West Virginia University, Morgantown, West Virginia, USA.
Insights
Polysomnography (PSG) reveals developmental changes in sleep patterns for healthy children aged 3-7 years. These findings provide extensive normative reference values for pediatric sleep studies.
Area of Science:
- Pediatric Sleep Medicine
- Neuroscience
- Developmental Pediatrics
Background:
- Polysomnography (PSG) is crucial for diagnosing sleep disorders in children.
- Establishing normative PSG values in healthy children is essential for accurate diagnosis.
- Limited data exists on normative sleep parameters for preschool and early school-aged children.
Purpose of the Study:
- To characterize overnight polysomnographic (PSG) measures in healthy children aged 3 to 7 years.
- To establish normative reference values for pediatric polysomnography in this age group.
- To identify developmental changes in sleep cyclicity and respiratory events.
Main Methods:
- Retrospective analysis of PSG data from 542 healthy children (ages 3.2-8.6 years).
- Exclusion criteria included snoring, elevated apnea-hypopnea index (> or =1.0), or periodic leg movement index (> or =5.0).
- Analyses were stratified into two age groups: 3-5 years and > or =6 years.
Main Results:
- Significant differences in sleep cyclicity were observed between the two age groups.
- Average obstructive apnea indices were low (0.03/hr for 3-5 yrs, 0.05/hr for >6 yrs).
- Central apnea indices were higher (0.82/hr for 3-5 yrs, 0.45/hr for >6 yrs), with variations by body position.
Conclusions:
- Developmental shifts in PSG measures occur in healthy children aged 3-7 years.
- These changes are particularly notable during the transition from preschool to early school age.
- This study provides the most extensive compilation of normative reference values for pediatric polysomnography to date.
Objective:
The objective of this study was to describe overnight polysomnographic measures in normal children aged 3 to 7 years. We conducted a retrospective analysis of normal polysomnographic evaluations from participants in 2 large community-based studies of sleep-disordered breathing among preschoolers and early school-aged children at Kosair Children's Hospital Sleep Medicine Research Center at the University of Louisville. Participants included 542 healthy children with ages ranging from 3.2 to 8.6 years.
Results:
Subjects were excluded from analysis if they had documented snoring during polysomnography, an obstructive apnea-hypopnea index of > or =1.0, or a periodic leg-movement index of > or =5.0. Because the greatest differences in polysomnography occurred between ages 5 and 6 years, analyses were performed for children 3 to 5 years and for ages > or =6. Sleep cyclicity was distinct between age groups, with both showing an initial brief rapid-eye-movement period, which lengthened across the night, but only the older group showing a decrease in cycle length across the night. Average obstructive apnea indices were 0.03 per hour of total sleep time (TST) for 3- to 5-year-old children and 0.05 per hour of TST for > or =6-year-old children, whereas central apnea indices were 0.82 and 0.45 per hour of TST, respectively. Older children spent a greater percentage of sleep time supine, and the apnea-hypopnea index differed according to body position. Twenty percent of all subjects had end tidal carbon dioxide values of >45 mm Hg, and 2.2% had recorded values >50 mm Hg during > or =50% TST. High variance was present on all measures.
Conclusions:
Developmental changes occur in several polysomnographic measures among normal children from 3 to 7 years of age, particularly during transition from preschool to early school age. Our findings in a large number of healthy community children comprise the most extensive compilation of normative reference values for laboratory-based pediatric polysomnography to date.
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