title: Correlation between REM AHI and quality-of-life scores in children with sleep-disordered breathing.
abstract: OBJECTIVE
  Prior research has demonstrated poor correlation between the obstructive apnea-hypopnea index (AHI) on full-night polysomnogram (PSG) and quality-of-life (QOL) scores. We aim to examine the association between rapid eye movement (REM) AHI and QOL scores in children with sleep-disordered breathing (SDB).
  
  
  METHODS
  Prospective trial.
  
  
  METHODS
  Two tertiary children's hospitals.
  
  
  METHODS
  Children between 3 and 16 years of age with suspected SDB who were undergoing PSG were eligible. Children with craniofacial anomalies were excluded. Subjects' caregivers completed the Obstructive Sleep Apnea-18 (OSA-18), a validated QOL survey. Power analysis determined a group size of 34.
  
  
  RESULTS
  One hundred twenty-seven patients were enrolled. The mean (SD) age was 6.3 (3.3) years. Most subjects (52%) were black and 26% were obese. The mean (SD) obstructive AHI of the subject population was 5.4 (11.9), while the mean (SD) REM AHI was 13.1 (23.7). The mean total OSA-18 score was 65.2, indicating a moderate impact of SDB on QOL. Neither the obstructive AHI (P = .73) nor the REM AHI (P = .49) correlated with total OSA-18 scores. However, lower nadir oxygen saturation was associated with significantly poorer QOL (P = .02). The sleep disturbance OSA-18 subset score significantly correlated with both the obstructive AHI (r (2) = 0.22; P = .01) and the REM AHI (r (2) = 0.22; P = .01); the remaining 4 subset scores did not correlate with either factor.
  
  
  CONCLUSIONS
  Neither obstructive AHI nor REM AHI correlates with total OSA-18 QOL scores. With the exception of nadir oxygen saturation, PSG parameters do not reflect the burden of SDB on QOL in children.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, and Department of Pediatric Otolaryngology, Children's Hospital of the King's Daughters, Norfolk, Virginia, USA cristina.baldassari@chkd.org baldassc@gmail.com.
authors.forename: Cristina Marie
authors.initials: CM
authors.lastname: Baldassari
authors.affiliation: Eastern Virginia Medical School, Norfolk, Virginia, USA.
authors.forename: Lyla
authors.initials: L
authors.lastname: Alam
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Vigilar
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: James
authors.initials: J
authors.lastname: Benke
authors.affiliation: Eastern Virginia Medical School, Graduate Program in Public Health, Norfolk, Virginia, USA.
authors.forename: Charley
authors.initials: C
authors.lastname: Martin
authors.affiliation: Departments of Pediatric Otolaryngology-Head & Neck Surgery & Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, and Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA.
authors.forename: Stacey
authors.initials: S
authors.lastname: Ishman
mesh_terms: D000293:Adolescent; D001784:Blood Gas Analysis; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D011446:Prospective Studies; D011788:Quality of Life; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D012895:Sleep, REM / Q000502:physiology*
keywords: obstructive sleep apnea; pediatrics; polysomnogram; quality of life