Normative values of polysomnographic parameters in childhood and adolescence: cardiorespiratory parameters

Area of Science:

• Pediatric Sleep Medicine
• Cardiorespiratory Physiology
• Developmental Pediatrics

Background:

• Establishing normative values for pediatric sleep cardiorespiratory parameters is crucial for diagnosing sleep-related breathing disorders.
• Existing data may not fully capture developmental changes across a wide age range or adhere to current standards.

Purpose of the Study:

• To establish normative values for pediatric sleep cardiorespiratory parameters based on American Academy of Sleep Medicine (AASM) criteria.
• To investigate the influence of gender, age, and Tanner stage on these parameters in healthy children.

Main Methods:

• One-night polysomnography was conducted in 16 laboratories on 209 healthy German children aged 1-18 years.
• Data were collected during habitual sleep times to reflect real-world sleep conditions.

Main Results:

• Normative cardiorespiratory sleep values were determined. Obstructive and mixed apneas were absent; hypopneas were infrequent.
• Respiratory frequency and apnea-hypopnea-index significantly decreased with age (p<0.001). Heart rate showed an inverse correlation with age (p<0.001) and was lower during sleep, particularly in stage N.
• While central apneas (≥ 20s) were present but uncommon, oxygen desaturations and respiratory arousals post-central apnea were rare. Heart rate was higher in females than males (p<0.05).

Conclusions:

• Age-related normative values for pediatric sleep cardiorespiratory parameters were successfully established using AASM rules.
• These developmental norms are essential for improving the accuracy of identifying and diagnosing sleep pathologies in children.
• While age significantly impacts most parameters, Tanner stage and corresponding age had limited influence on specific indices like apnea and hypopnea rates.