Home monitoring using portable polygraphy for perioperative assessment of pediatric obstructive sleep apnea syndrome.

OBJECTIVE To overcome very few facilities available for polysomnography, a portable device of polygraphy was introduced into home monitoring for the assessment of obstructive sleep apnea syndrome (OSAS) in children. METHODS Forty-eight children (aged 2-11) presenting with snoring and sleep apnea were subjected to home monitoring. Sleeptester™ (Fukuda Lifetech, Japan) was used for this purpose, which was equipped with 5 channels for oronasal airflow, thoracoabdominal effort, snoring, body position, and oximetry (SpO2). Sensors were placed by guardians, and they were requested to attend their children as long as possible during a night. Results were analyzed manually by sleep technologists. Adenotonsillectomy was performed in all 48 children, and the same monitoring was utilized postoperatively. RESULTS The mean duration of monitoring was 460 ± 172 min. (Mean ± S.D.) in the preoperative test and 471 ± 126 min. in the postoperative test. The mean apnea-hypopnea index (AHI) was 20.6 ± 16.6 and 4.4 ± 2.1, respectively. There was a statistically significant decrease (p < 0.001). The lowest SpO2 value was 76.7 ± 17.1% preoperatively and 80.8 ± 14.6% postoperatively, demonstrating no significant difference (p = 0.16) CONCLUSION Attended home monitoring by guardians using a portable device can be useful in the perioperative assessment of pediatric OSAS.

[1]  J. Farber,et al.  Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. , 2002, Pediatrics.

[2]  L. Kheirandish-Gozal,et al.  The multiple challenges of obstructive sleep apnea in children: morbidity and treatment , 2008, Current opinion in pediatrics.

[3]  Sabin R. Bista,et al.  Practice parameters for the respiratory indications for polysomnography in children. , 2011, Sleep.

[4]  U. Tolonen,et al.  Snoring and obstructive sleep apnea in children: a 6-month follow-up study. , 2000, Archives of otolaryngology--head & neck surgery.

[5]  A. Chesson,et al.  The American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications , 2007 .

[6]  C. Marcus,et al.  Natural history of primary snoring in children , 1998, Pediatric pulmonology.

[7]  Schechter Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome : Technical report : diagnosis and management of childhood obstructive sleep apnea syndrome , 2002 .

[8]  W. Ward Flemons,et al.  Home diagnosis of sleep apnoeas: A systematic review of the literature , 2003 .

[9]  W. Flemons,et al.  Home diagnosis of sleep apnea: a systematic review of the literature. An evidence review cosponsored by the American Academy of Sleep Medicine, the American College of Chest Physicians, and the American Thoracic Society. , 2003, Chest.

[10]  K. Waters,et al.  Nocturnal Pulse Oximetry as an Abbreviated Testing Modality for Pediatric Obstructive Sleep Apnea , 2000 .

[11]  M. Mograss,et al.  Home testing for pediatric obstructive sleep apnea syndrome secondary to adenotonsillar hypertrophy , 1995, Pediatric pulmonology.

[12]  L. Brooks,et al.  Adenotonsillectomy for treatment of obstructive sleep apnea in children. , 1995, Archives of otolaryngology--head & neck surgery.

[13]  A. Pack,et al.  Practice parameters for the use of portable monitoring devices in the investigation of suspected obstructive sleep apnea in adults. , 2003, Sleep.

[14]  A. Kataura,et al.  The effect of adenotonsillectomy in children with OSA. , 1998, International journal of pediatric otorhinolaryngology.

[15]  R. Chervin,et al.  Identification and evaluation of obstructive sleep apnea prior to adenotonsillectomy in children: a survey of practice patterns. , 2003, Sleep medicine.