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Normative values of polysomnographic parameters in Chinese children and adolescents: a cross-sectional study
Guixiang Wang1, Zhifei Xu2, Jun Tai1
1Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Insights
This study established normal polysomnography values for children aged 3-14, finding age-specific differences in sleep architecture and central apnoea events. These findings highlight the need for age-adjusted reference values in pediatric sleep assessments.
Area of Science:
- Pediatric Sleep Medicine
- Clinical Neurophysiology
- Respiratory Physiology
Background:
- Establishing normative data for polysomnography (PSG) in children is crucial for diagnosing sleep disorders.
- Previous studies may lack age-specific reference values, potentially leading to misinterpretation of results in pediatric sleep evaluations.
- Understanding variations in sleep architecture and respiratory events across different pediatric age groups is essential for accurate clinical assessment.
Purpose of the Study:
- To characterize age-specific normal polysomnography values in healthy children.
- To establish reliable reference values for pediatric sleep studies.
- To compare sleep architecture, respiratory events, and oxygen saturation between young (3-5 years) and older (6-14 years) children.
Main Methods:
- Recruitment of healthy children and adolescents aged 3-14 years.
- Division into two age groups: young (3-5 years) and old (6-14 years).
- Conducting overnight polysomnography (PSG) and comparing sleep parameters, respiratory events, and oxygen saturation between groups.
Main Results:
- The older group exhibited higher N2 sleep and lower R sleep percentages compared to the younger group.
- Total Apnea-Hypopnea Index (AHI) differed significantly between age groups (p=0.007), with higher values in younger children.
- Central Apnea Index (CAI) was significantly higher in the young group (p=0.001), impacting mean lowest oxygen saturation (SaO2).
Conclusions:
- Findings align with existing data on sleep architecture and respiratory events in healthy children.
- Central apnoea occurrence demonstrates age-related variability, necessitating age-specific cut-off values.
- Recommended use of distinct normal reference ranges for polysomnography in different pediatric age cohorts.
Objective:
The objectives of this study were to characterise age-specific normal polysomnography values in healthy children and to establish reference values for paediatric sleep studies.
Methods:
Healthy children and adolescents aged 3-14 years were recruited from families of hospital employees. The subjects were divided into young (three to five years old) and old (6-14 years old) groups. Each child was subjected to overnight polysomnography. The polysomnographic parameters of sleep architecture, respiratory events and oxygen saturations of the two groups were compared.
Results:
Ninety-nine subjects, including 33 3-5 year olds and 66 6-14 years olds, were recruited. The old group yielded a higher per cent of N2 sleep and lower per cent of R sleep than the young group. Sleep efficiency and latency were similar between the two groups. The average of the total apnoea/hypopnoea index (AHI) was different between the two groups (1.02 ± 0.99 vs 0.51 ± 0.57, p = 0.007). The average central apnoea index (CAI) in the young group was higher than that of the old group (0.7 ± 0.82 vs 0.28 ± 0.42, p = 0.001), with 97.5 percentile of 3.8 and 1.4, respectively. The obstructive apnoea index (OAI) and obstructive apnoea hypopnoea index(OAHI) were similar in the two groups (OAI: 0.08 ± 0.12 and 0.07 ± 0.14, and OAHI: 0.18 ± 0.21 and 0.19 ± 0.26, respectively). The mean lowest SaO2 in the young group was significantly lower than that of the old group because of central apnoea events.
Conclusions:
The findings were consistent with previously published data regarding sleep architecture, oxygen saturations, and relative rarity of respiratory events in normal children. The occurrence of central apnoea varied with age. Therefore, it is suggested that different normal cut-off values be used for children in different age groups.
