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Respiratory Volumes and Capacities I

Respiratory Volumes and Capacities I

Assessing the respiratory rate and rhythm for a complete minute is crucial for evaluating the breathing pattern. Even a minor increase in the patient's average respiratory rate, by as little as three to five breaths per minute, is an early and vital indicator of respiratory distress. Patients with a respiratory rate exceeding twenty-four breaths per minute require close monitoring to determine the physiological alterations. This careful observation is essential for prompt recognition and...

Respiratory Assessment: Purpose and Indications

Respiratory Assessment: Purpose and Indications

Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...

Respiratory System Abnormal Finding I: Inspection and Percussion

Respiratory System Abnormal Finding I: Inspection and Percussion

Respiratory system abnormalities are a significant concern in healthcare due to their potential to indicate underlying severe conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, and pneumonia. These abnormalities can often be detected through physical examination methods like inspection and percussion.
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...

Hyperpnea and Hyperventilation

Hyperpnea and Hyperventilation

Hyperventilation refers to a higher-than-normal rate and depth of breathing, often associated with anxiety attacks. This excessive breathing surpasses the body's need to expel CO2, leading to a condition known as hypocapnia - an unusually low level of carbon dioxide in the blood. Hypocapnia can constrict cerebral blood vessels, reducing blood flow to the brain, which may result in dizziness or fainting. Early signs include tingling and muscle spasms in the hands and face, caused by falling...

Alterations in Respiration II

Alterations in Respiration II

There are numerous types of normal and abnormal respiration. Based on ventilatory movements, breathing patterns are classified as regular, deep, or shallow. Examples include Biot's breathing, Cheyne-Stokes respiration, Kussmaul's breathing, hyperventilation, and hypoventilation. Each pattern is clinically significant and aids in evaluating patients.
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include...

Assessment of Ventilation I: Respiratory Rate

Assessment of Ventilation I: Respiratory Rate

Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
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Related Experiment Video

Updated: May 31, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

Current hypopnea scoring criteria underscore pediatric sleep disordered breathing.

Cheng-Hui Lin¹, Christian Guilleminault

¹Stanford University Sleep Medicine Division, Stanford, CA, USA.

|June 25, 2011

Summary

The American Academy of Sleep Medicine (AASM) criteria significantly underdiagnosed obstructive sleep apnea (OSA) in children compared to Stanford criteria. This highlights potential issues with AASM hypopnea scoring in pediatric sleep disordered breathing (SDB) diagnosis.

Related Experiment Videos

Last Updated: May 31, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

Area of Science:

Pediatric Sleep Medicine
Respiratory Physiology
Diagnostic Criteria Evaluation

Background:

Accurate diagnosis of pediatric sleep disordered breathing (SDB) is crucial for child health.
Different scoring criteria for polysomnograms (PSGs) may lead to variations in SDB diagnosis.
The 2007 American Academy of Sleep Medicine (AASM) pediatric scoring criteria and Stanford scoring criteria are commonly used.

Purpose of the Study:

To compare the 2007 AASM pediatric scoring criteria with Stanford scoring criteria for pediatric polysomnograms.
To evaluate the impact of different scoring systems on the diagnosis of sleep disordered breathing (SDB) in children.
To characterize the differences in obstructive sleep apnea (OSA) diagnosis rates between the two scoring systems.

Main Methods:

Retrospective analysis of diagnostic and post-treatment nocturnal polysomnograms (PSGs) from children (age 2-18 years) with suspected SDB.
Independent, blinded analysis of PSGs using both AASM and Stanford scoring criteria by a single researcher.
Comparison of diagnostic yield and apnea-hypopnea index (AHI) between the two scoring systems.

Main Results:

The Stanford criteria identified 207 abnormal PSGs, while the AASM criteria identified only 39 abnormal PSGs out of 209 total.
Stanford criteria diagnosed OSA in 99% of referred children, whereas AASM criteria diagnosed OSA in only 19%.
AASM AHI was significantly lower and skewed compared to Stanford AHI; all 99 treated children showed improvement with Stanford criteria.

Conclusions:

The AASM scoring criteria significantly underdiagnosed OSA in children compared to the Stanford criteria.
The scoring of hypopneas is a primary factor differentiating the two criteria.
The current AASM definition of hypopnea may hinder the accurate recognition of SDB in pediatric populations.