Movement/arousals. Description, classification, and relationship to sleep apnea in children.
Movement/arousal has been described as a characteristic of adult obstructive sleep apnea syndrome (OSAS), but opinions differ as to whether or not OSAS in children increases the frequency of movement/arousal. The problem that we decided to address was the lack of a comprehensive definition and characterization of movement/arousals in children. We therefore quantified and classified movement/arousals during nocturnal polysomnography in 15 children 5.2 +/- 2.7 SD yr of age being evaluated for OSAS. Movement/arousals were defined by modifying the standard criteria for scoring arousals in adults. Median respiratory disturbance index was 4.4/h, with a range of 1 to 28/h. Videotape review was required to adequately distinguish technician-induced from spontaneous movement/arousals. Although movement/arousal durations varied from 1 s to prolonged awakenings, a high frequency of brief, 1- to 3-s movement/arousals occurred in all classification categories: respiratory, 44%; technician-induced, 33%; spontaneous, 36%. When comparing a 16-channel PSG montage with that of a seven-channel cardiorespiratory montage, we found that 84% of all movement/arousals could be detected using the abbreviated montage. In conclusion, we propose a simple classification system that distinguishes three types of movement/arousals: respiratory, technician-induced, and spontaneous. Our results further suggest that a simple montage using cardiorespiratory channels and videotaping would be suitable for home study and sensitive for identifying movement/arousals.
Department of Pediatrics, Montreal Children's Hospital, Québec, Canada.
M A
MA
Mograss
F M
FM
Ducharme
R T
RT
Brouillette
D000704:Analysis of Variance; D001143:Arousal / Q000145:classification / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009068:Movement / Q000502:physiology*; D017286:Polysomnography / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D012891:Sleep Apnea Syndromes / Q000145:classification / Q000503:physiopathology*; D012894:Sleep Stages / Q000502:physiology; D018709:Statistics, Nonparametric; D014743:Videotape Recording / Q000295:instrumentation / Q000379:methods