Polysomnographic values in children undergoing puberty: pediatric vs. adult respiratory rules in adolescents.
OBJECTIVE
Polysomnographic respiratory events in children should be scored using pediatric respiratory rules. However, due to a lack of data on adolescents, recently revised rules allow children aged 13-18 years to be scored by adult or pediatric criteria. To clarify which criteria to use, we describe the evolution of respiratory events with Tanner stage, and we compare events in children aged 13-18 years with the new American Academy of Sleep Medicine adult and pediatric respiratory rules.


METHODS
Cross-sectional


METHODS
Academic hospital


METHODS
Healthy subjects aged 8-18 years recruited for research purposes.


METHODS
Physical examination to determine Tanner stage, overnight polysomnogram, and determination of sex hormones.


RESULTS
Sixty-eight subjects (Tanner 1-5) were studied, mean age [SD] = 13 +/- 3 years, median apnea hypopnea index (AHI)= 0.1 (range: 0-1.2)/h. The median percentages of total sleep time (TST) with SpO2 < 92% were 0.1 (0-4.2)%, and with end-tidal CO2 > 50 torr was 0.1 (0-88.6)%. Thirty-two subjects were aged 13-18 years, (Tanner 3-5). The difference between AHI scored by pediatric (median = 0 [0-0.9]/h) and adult (median = 0 [0 - 0.5]/h) criteria was statistically significant (P = 0.043), but not clinically relevant.


CONCLUSIONS
Respiratory events in normal children aged 8-18 years are rare and unrelated to Tanner stage. Adult or pediatric respiratory rules can be used for scoring polysomnograms in asymptomatic subjects approaching adulthood. Further studies are needed in symptomatic children within this age group.
Tapia
Ignacio E
IE
Sleep Center, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104 USA.
Karamessinis
Laurie
L
Bandla
Preetam
P
Huang
Jingtao
J
Kelly
Andrea
A
Pepe
Michelle
M
Schultz
Brian
B
Gallagher
Paul
P
Brooks
Lee J
LJ
Marcus
Carole L
CL
D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000502:physiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D020189:Nocturnal Myoclonus Syndrome / Q000175:diagnosis / Q000503:physiopathology; D017286:Polysomnography / Q000145:classification / Q000706:statistics & numerical data*; D011627:Puberty / Q000502:physiology*; D012123:Pulmonary Ventilation / Q000502:physiology*; D012016:Reference Values; D020182:Sleep Apnea, Central / Q000175:diagnosis / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology; D012894:Sleep Stages / Q000502:physiology