First night effect for polysomnographic data in children and adolescents with suspected sleep disordered breathing.
OBJECTIVE
To assess the presence of a first night effect (FNE) in children and adolescents and to examine if a single night polysomnography (PSG) is sufficient for diagnosing obstructive sleep apnoea syndrome (OSAS).


METHODS
Prospective case study of 70 patients (group 1: 2-6 years, n = 22; group 2: 7-12 years, n = 32; group 3: 13-17 years, n = 16) referred for OSAS. Diagnostic criteria for OSAS: one or more of the following: (1) obstructive apnoea index (OAI) > or =1; (2) obstructive apnoea hypopnoea index (oAHI) > or =2; (3) SaO2 < or =89% in association with obstruction.


RESULTS
In all age groups, but mainly in the oldest children, REMS increased during the second night, mainly at the expense of stage 2 sleep. The first night PSG correctly identified OSAS in 86%, 91%, and 100% of the children for groups 1, 2, and 3 respectively. This represents 9% false negatives for OSAS when only the first night PSG was used. All cases missed had mild OSAS, except for one with oAHI >5 on night 2. There were also seven patients with OSAS on night 1 but with a normal PSG on night 2: all had oAHI <5.


CONCLUSIONS
There is a FNE in children and adolescents. A single night PSG is sufficient for diagnosing OSAS, but in cases with a suggestive history and examination and with a negative first night, a second night study might be advisable.
Verhulst
S L
SL
Department of Pediatrics, University Hospital of Antwerp, Belgium. stijn.verhulst@ua.ac.be
Schrauwen
N
N
De Backer
W A
WA
Desager
K N
KN
D000293:Adolescent; D000886:Anthropometry; D002648:Child; D002675:Child, Preschool; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood; D017286:Polysomnography / Q000379:methods*; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D012895:Sleep, REM; D013997:Time Factors
D010100:Oxygen