[Reliability of respiratory polygraphy for the diagnosis of sleep apnea-hypopnea syndrome in children].
OBJECTIVE
Overnight polysomnography (PSG) is the gold standard diagnostic tool for sleep apnea-hypopnea syndrome (SAHS) in children. The aim of the present study was to evaluate the usefulness of diagnostic respiratory polygraphy in children with clinically suspected SAHS referred to our sleep-disordered breathing clinic.


METHODS
We studied 53 children referred with clinical suspicion of SAHS; 29 (54.7%) were boys and the mean (SD) age was 6.4 (2.9) years. After a medical history was taken and a physical examination performed, patients underwent respiratory polygraphy (Edentec) simultaneously with overnight PSG in the sleep laboratory. The 2 diagnostic tools were compared using statistical analysis.


RESULTS
SAHS was defined by an obstructive apnea-hypopnea index (OAHI) of 3 or more in overnight PSG and a respiratory disturbance index (RDI) of 3 or more in respiratory polygraphy. The rate of diagnostic agreement was 84.9%. The difference between the mean OAHI and RDI values was not significant (0.7 +/- 5.4; P=.34). The intraclass correlation coefficient between the OAHI and RDI was 89.4 (95% confidence interval, 82.4-93.7; P< .001). When receiver operating characteristic curves were calculated for the OAHI cutoff points used for the diagnosis of SAHS (> or =1, > or =3, and > or =5), the best RDI cutoff for all 3 OAHI values considered was found to be 4.6. When age strata were considered, in children 6 years or older the best RDI cutoff for the 3 OAHI values was 2.1. In children younger than 6 years the best RDI cutoff was 3.35 for OAHI > or =1 and 5.85 for OAHI > or =3 and > or =5.


CONCLUSIONS
Respiratory polygraphy in the sleep laboratory is a valid method for the diagnosis of SAHS in children.
Alonso Alvarez
María Luz
ML
Unidad de Trastornos Respiratorios del Sueño, Sección de Neumología, Complejo Asistencial de Burgos, Burgos, Spain. mari63@separ.es
Terán Santos
Joaquín
J
Cordero Guevara
José Aurelio
JA
Navazo Egüia
Ana Isabel
AI
Ordax Carbajo
Estrella
E
Masa Jiménez
Juan Fernando
JF
Pelayo
Rafael
R
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D011446:Prospective Studies; D015203:Reproducibility of Results; D012891:Sleep Apnea Syndromes / Q000175:diagnosis*