小児閉塞性睡眠時呼吸障害の診断―臨床症状に基づく診断の精度の検討―

Abstract

The decision to perform adenotonsillectomy or tonsillectomy for treatment of pediatric Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) is often based solely on clinical history such as snoring, sleep apnea or sleep disturbance, not on an objective evaluation. To determine the accuracy of clinical diagnosis of OSAHS in children, we performed overnight objective measurements in 35 patients (1.9-12 years old: 21 boys and 14 girls) who presented at our clinic from January 1997 to December 2000. An oxygen desaturation index (ODI)>5/h or minimal oxygen saturation (min SaO2)<90% were the defining criteria for OSAHS. Only 22 of 35 patients who had clinical diagnosis of OSAHS met the criteria. The remaining 13 patients were diagnosed as having simple snoring. There was no significant differences in age, gender, obesity, tonsil size and adenoid hypertrophy between OSAHS and the simple snoring patients group. OSAHS in children cannot be reliably distinguished from simple snoring by clinical diagnosis alone.