Abstract
Attended overnight polysomnography (PSG) performed in a sleep laboratory is the currently accepted technique used for the diagnosis of sleep apnea/hipopnea syndrome (SAHS) in children. Respiratory Polygraphy (RP) in children has been validated in the sleep laboratory. AIM: To evaluate the reliability diagnostic of home respiratory Polygraph (HRP) in children with a clinical suspicion of SAHS referred to one sleep unit. Cross-sectional study. We included children aged 2–14 years, of both sexes, with clinical suspicion of SAHS referred to the Sleep Unit on randomly selected days. The whole group underwent clinical history, physical examination, a first home respiratory polygraphy (HRP) and between 1 and 2 weeks later underwent a second PR and PSG in the same night in sleep laboratory. The criteria of the AASM 2007 were used for the assessment of sleep and respiratory events. We calculated the normal index of RP and PSG: Respiratory disturbance index (RDI), Obstructive respiratory disturbance index (oRDI) Obstructive Apnea-Hypopneas Obstructive index (oAHI). Intraclass correlation coefficients (ICC), Bland-Altman plots and receiver operator curves (ROC) were calculated for statistical analysis. We calculated confidence intervals at 95%. We studied 27 boys and 23 girls with a mean age of 5.3 (SD: 2.55). 39 (78%), 33 (66%), 26 (52%) were diagnosed with SAHS, when RDI ⩾ 3, oRDI ⩾ 3 and OAHI ⩾ 3 were taken as diagnosis of SAHS. The average of RDI was 13.92 (SD16, 57), 14.46 (SD: 13.23), 16.47 (SD: 15.32) in the PSG, Home RP, RP at laboratory respectively. The area under the ROC curve for RDI ⩾ 3, oRDI ⩾ 3 and OAHI ⩾ 3 in the laboratory RP were 93.5 (85.5 - 1), 96.8 (92.1 - 1), 95, 5 (90.6 - 1) and in the HRP were 93.5 (86.8 - 1), 93.9 (87.0 - 1), 92.9 (85.9 - 1), respectively. Home respiratory polygraphy has a good agreement with the values of the PSG Respiratory Poligraphy performed at home is a useful technique for diagnosis of SAHS in children. Funded by Ministry of Health Castilla – Leon and SEPAR.
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