Sleep Disorders: Sleep Disorders 1 |

A Significant AHI During NAP Polysomnography in Pediatric OSA FREE TO VIEW

Teeradej Kuptanon, MD
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Ramathibodi Hospital, Bangkok, Thailand

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):1271A. doi:10.1016/j.chest.2016.08.1385
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SESSION TITLE: Sleep Disorders 1

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: To find a significant AHI value during Nap polysomnography in Pediatric OSA.

METHODS: Snoring pediatric patients with regular nap schedule were informed and consented but we excluded those with medication affecting sleep. Patients underwent overnight polysomnography and nap polysomnography separately, but within 2 month of each other. Both tests were done with the same recording devices and in the same manner. Patient’s sleep behavior was observed by a sleep technician and were categorized into primary snoring, mild OSA, moderate OSA and severe OSA by apnea-hypopnea index (AHI). Sleep parameters between nap-PSG and standard-PSG were compared.

RESULTS: There were twenty nine patients (62.1% male) with median aged and IQR was 5 years old [4.5-6] and median BMI was 15.9 kg/m2[14.0-19.2], were recruited. The median AHI, arousal index of nap-PSG was 5.5 events/hour [2.0- 20.9] and 21.2 events/hour [11.8-34.1], respectively, whereas those of standard-PSG were 6.9 events/hour [4.0-14.8] and 17.8 events/hour [14.8-31.1] respectively. There was no statistical significant between both groups. The best accuracy cut-point for nap-PSG to diagnosis for OSA is 2.5 events/hour, which yield sensitivity and specificity 73.1% and 100% respectively. Scatter plot showed a monotonic relationship between AHI from both tests. Spearman’s rank correlation coefficient revealed a moderate positive correlation (P-value = 0.001, correlation coefficient = 0.59). From the treatment standpoint, the AHI cut-point criterion for surgery is usually more than 5 events/hour. We found that using nap-PSG AHI cut-off point more than 20 events/hour also yielded a good positive predictive value to considered surgery, which was 100%. Conclusions

CONCLUSIONS: Nap-PSG shows a promising trend as an alternative diagnostic tool for standard PSG and may help considering surgery in clinical urgency cases by using nap-PSG AHI cut-off more than 20 events/hour. Further study is needed with larger sample size to find the conclusion.

CLINICAL IMPLICATIONS: Decrease complications of pediatric OSA while waiting for overnight PSG.

DISCLOSURE: The following authors have nothing to disclose: Teeradej Kuptanon

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