Polygraphy in hospitalized pediatric patients: A real-life practice

The gold standard test for diagnosing sleep-disordered breathing is polysomnography; however, its limited availability has led to the emergence of alternatives such as polygraphy, which is more accessible and cost-effective.

To analyze the association between underlying conditions and obstructive sleep apnea-hypopnea syndrome in children with suspected sleep-disordered breathing.

Retrospective cross-sectional study. Polygraphy studies of hospitalized children aged ≥1 year with suspected sleep-disordered breathing were included. Demographic, clinical, and polygraphic variables were collected. A logistic regression analysis was performed to evaluate the presence of obstructive sleep apnea-hypopnea syndrome according to underlying conditions.

Of 1,000 polygraphy studies, 407 were analyzed. The median age was 8.2 years (range 4.1-12.2), with 56% male patients. The main diagnoses were neurological impairment (19.4%), neuromuscular diseases (16.0%), upper airway obstruction (15.5%), and chronic lung disease (15.5%). Abnormal polygraphy was found in 56.0% of cases, with obstructive sleep apnea syndrome classified as mild in 63.0%, moderate in 21.0%, and severe in 16.0%, with obesity and neuromuscular diseases being most prominent. Significant differences were found in age (p=0.001) and apnea-hypopnea index (p=0.002) across diagnostic categories. Children with Down syndrome had a 5.5-fold higher risk of obstructive sleep apnea-hypopnea syndrome compared to those with chronic lung disease.

There was a high prevalence of obstructive sleep apnea-hypopnea syndrome, particularly in children with obesity and neuromuscular diseases. Patients with Down syndrome had a higher risk of obstructive sleep apnea-hypopnea syndrome compared to those with chronic lung disease. Polygraphy is a potentially implementable tool in healthcare centers with similar characteristics.