Study of Obstructive Sleep Apnea in Children / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Tonsillectomy for upper airway obstruction in children has increased but there isn't enough objective data to support such assessment. The purpose of this study was to establish some objective guide for surgery in obstructive apneic children using polysomnography and to compare the polysomnographic results with predictive clinical data, so as to determine the prevalence of obstructive sleep apnea (OSA) with suggestive history. We also tried to understand the characteristics of OSA in children. MATERIALS AND METHODS:Predictive value of OSA was scored based on history, physical examination and X-ray images and compared with the standard overnight polysomnography in fifty-one children who were suggestive of OSA. Postoperative polysomnography was performed in five children who remained apneic. RESULTS: Twenty-two (43%) children with suggestive OSA had respiratory disturbance index (RDI) greater than 5. Among thirty-five (68.6%) who underwent surgery, five (9.8%) children remained apneic with snoring but mean and the longest apnea duration reduced significantly. There was no difference between the obstructive group and non-obstructive group in sleep architecture but minimum oxygen saturation, apnea index, mean apnea duration and hypopnea index showed significant difference. Predictive clinical score and RDI had weak correlation (r=0.25). Non-obstructive group showed higher composition of centeral apnea than the obstructive group. CONCLUSION: History, physical examination and X-ray studies alone are not sufficient to assess the severity of OSA. Polysomnographic study adjusted for children should be done for correct diagnosis in children who do not show any other indication for surgery.