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Published on: December 6, 2016
Descriptive analysis of central sleep apnea in childhood at a single center
Fiona E Kritzinger1, Suhail Al-Saleh, Indra Narang
1Division of Pediatric Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada. drkritzinger@thrivingkids.co.za
Insights
Central sleep apnea (CSA) affects over 5% of children evaluated for sleep-disordered breathing. Neurological disorders are a common risk factor in pediatric CSA patients, necessitating further clinical assessment.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
Background:
- Central sleep apnea (CSA) data in children is limited.
- Understanding CSA's significance in pediatric populations is crucial.
Purpose of the Study:
- To describe polysomnogram (PSG) characteristics of children with significant CSA.
- To identify clinical features associated with pediatric CSA.
Main Methods:
- Retrospective chart review of pediatric patients diagnosed with CSA via PSG.
- Inclusion criteria: Central Apnea Index (CAI) > 5 events/hr.
- Data collected from January 2007 to December 2008 at a single pediatric sleep center.
Main Results:
- 5.4% of evaluated children had significant CSA (CAI > 5/hr).
- Median age was 19 months; median BMI z-score was +0.27.
- Neurological disorders were the most common risk factor; 24% had associated hypoventilation.
Conclusions:
- CSA is a significant finding in children with suspected sleep-disordered breathing.
- Children diagnosed with CSA require thorough clinical evaluation, including neuro-imaging.
- Further research is needed on the long-term outcomes of pediatric CSA.
Unlabelled:
Data on central sleep apnea (CSA) and its significance in children are limited. Our objectives were to describe the polysomnogram (PSG) characteristics and clinical features of children with significant CSA at a single pediatric sleep center.
Study Design And Methods:
A retrospective chart review of children diagnosed with CSA on a PSG, from January 2007 to December 2008, was performed. All the PSG's were performed in the pediatric sleep laboratory at The Hospital for Sick Children in Toronto, Canada. All children diagnosed with significant CSA with a PSG was eligible for inclusion. Each PSG was conducted and scored according to the American Academy of Sleep Medicine standard. Significant CSA was defined as a central apnea index (CAI) of >5 events/hr. Outcome for each patient was defined by the percentage change in the CAI at follow up.
Results:
52/969 (5.4%) patients had a CAI > 5/hr on a baseline PSG. Of the 25/52 (13 males) patients who met inclusion criteria, the median age was 19 months (range 3-156 months) and their median BMI z score was +0.27 (range -2.95 to 3.02). The median CAI was 11 events/hr (range 6-198/hr). The mean oxygen saturations ranged from 92.8% to 98.5%, with a median of 97%. Six (24%) patients had associated sleep-related hypoventilation and none of the patients had periodic breathing. The commonest identifiable risk factor for CSA in the study population was a neurological disorder.
Conclusions:
This study confirms that CSA is an important finding in a significant number of young children referred for an evaluation for suspected sleep related disordered breathing. Any child diagnosed with CSA warrants full clinical assessment, including neuro-imaging. Future research should aim to evaluate the long term outcome of significant CSA.
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