title: Reliability of home respiratory polygraphy for the diagnosis of sleep apnea in children.
abstract: OBJECTIVE
  The objective of this study was to evaluate the diagnostic reliability of home respiratory polygraphy (HRP) in children with a clinical suspicion of OSA-hypopnea syndrome (OSAS).
  
  
  METHODS
  A prospective blind evaluation was performed. Children between the ages of 2 to 14 years with clinical suspicion of OSAS who were referred to the Sleep Unit were included. An initial HRP followed by a later date, same night, in-laboratory overnight respiratory polygraphy and polysomnography (PSG) in the sleep laboratory were performed. The apnea-hypopnea index (AHI)-HRP was compared with AHI-PSG, and therapeutic decisions based on AHI-HRP and AHI-PSG were analyzed using intraclass correlation coefficients, Bland-Altman plots, and receiver operator curves (ROCs).
  
  
  RESULTS
  Twenty-seven boys and 23 girls, with a mean age of 5.3 ± 2.5 years, were studied, and 66% were diagnosed with OSAS based on a PSG-defined obstructive respiratory disturbance index ≥ 3/h total sleep time. Based on the availability of concurrent HRP-PSG recordings, the optimal AHI-HRP corresponding to the PSG-defined OSAS criterion was established as ≥ 5.6/h The latter exhibited a sensitivity of 90.9% (95% CI, 79.6%-100%) and a specificity of 94.1% (95% CI, 80%-100%).
  
  
  CONCLUSIONS
  HRP recordings emerge as a potentially useful and reliable approach for the diagnosis of OSAS in children. However, more research is required for the diagnosis of mild OSAS using HRP in children.
authors.affiliation: Sleep Unit, Burgos, Spain. Electronic address: mlalonso@hubu.es.
authors.forename: María Luz
authors.initials: ML
authors.lastname: Alonso-Álvarez
authors.affiliation: Sleep Unit, Burgos, Spain; CIBER of Respiratory Diseases, Burgos, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Terán-Santos
authors.affiliation: Sleep Unit, Burgos, Spain; CIBER of Respiratory Diseases, Burgos, Spain.
authors.forename: Estrella
authors.initials: E
authors.lastname: Ordax Carbajo
authors.affiliation: Sleep Unit, Burgos, Spain; CIBER of Respiratory Diseases, Burgos, Spain.
authors.forename: José Aurelio
authors.initials: JA
authors.lastname: Cordero-Guevara
authors.affiliation: Sleep Unit, Burgos, Spain; CIBER of Respiratory Diseases, Burgos, Spain.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Navazo-Egüia
authors.affiliation: Instituto Carlos III, CIBERES, and the Hospital Universitario de Burgos, Burgos, Spain; Section of Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL.
authors.forename: Leila
authors.initials: L
authors.lastname: Kheirandish-Gozal
authors.affiliation: Instituto Carlos III, CIBERES, and the Hospital Universitario de Burgos, Burgos, Spain; Section of Sleep Medicine, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL.
authors.forename: David
authors.initials: D
authors.lastname: Gozal
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D017286:Polysomnography / Q000379:methods*; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000503:physiopathology