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P-wave dispersion as a simple tool for screening childhood obstructive sleep apnea syndrome

Chutima Kraikriangsri1, Anant Khositseth1, Teeradej Kuptanon1

  • 1Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University Bangkok, Thailand.

Sleep Medicine
|December 24, 2018
PubMed

Insights

P-wave dispersion (PWD) is elevated in children with obstructive sleep apnea syndrome (OSAS), especially in severe cases. This electrocardiography (ECG) measurement may serve as a valuable screening tool for childhood OSAS.

Area of Science:

  • Pediatric Cardiology
  • Sleep Medicine
  • Diagnostic Electrocardiography

Background:

  • Obstructive sleep apnea syndrome (OSAS) in children is typically diagnosed via polysomnography.
  • Electrocardiography (ECG) offers a potentially simpler diagnostic alternative.
  • P-wave dispersion (PWD), a measure of atrial electrical heterogeneity, is elevated in adult OSAS but unstudied in pediatric OSAS.

Purpose of the Study:

  • To investigate P-wave dispersion (PWD) in children diagnosed with OSAS.
  • To establish a PWD cut-off value for diagnosing childhood OSAS.
  • To assess the association between PWD and the severity of childhood OSAS.

Main Methods:

  • 12-lead surface ECGs were performed on 77 children with OSAS and 44 controls.
  • P-wave duration was measured using a digital caliper by a blinded researcher.
  • Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic cut-off value.

Main Results:

  • Children with OSAS exhibited significantly higher PWD (38.3 ms) compared to controls (25.5 ms) (p < 0.0001).
  • PWD was significantly higher in severe OSAS cases (48.5 ms) versus mild-to-moderate cases (35.5 ms) (p = 0.006).
  • A PWD cut-off of 26.5 ms demonstrated 89.6% sensitivity and 61.4% specificity (AUC = 0.839).

Conclusions:

  • P-wave dispersion is significantly increased in children with OSAS, correlating with disease severity.
  • PWD shows potential as a practical screening tool for identifying childhood OSAS.
  • Further research can validate PWD's role in routine pediatric sleep apnea screening.
Abstract

Keywords:
ArrhythmiaChildrenElectrocardiographyObstructive sleep apnea

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