Review of Pediatric Polysomnographic Studies over a 2-year Period in a Tertiary Care Hospital in Bengaluru, India

Abstract

ABSTRACT Introduction Pediatric polysomnography is the gold standard in diagnosing sleep-related breathing disorders, the most common cause of this being obstructive sleep apnea (OSA). Instituting good sleep hygiene measures, early recognition of symptoms and signs of sleep-disordered breathing, and timely referral for polysomnography play a vital role in improving a child's quality of life. We report our experience with sleep disorders in children and the challenges faced during diagnosis. Aims To review indications for pediatric sleep studies done over 2 years and their outcomes in a tertiary care center in Bengaluru, India. Methods Retrospective descriptive analysis of 65 pediatric sleep studies done between 2018 and 2020 (2-year period) for various indications. Results The total numbers of studies included in the analysis were 65, of which complete studies were done in 58 children and portable studies in 7 children. The most common indication for performing a sleep study was suspected OSA, followed by referrals for children with spinal muscular atrophy and Duchenne muscular dystrophy, respectively. Average age of the patient was 93.56 months (range 3–216 months). The number of boys and girls included in the study was 45 and 20, respectively. The average duration of sleep was 375.35 minutes, of which rapid eye movement (REM) sleep contributed to 45.33 minutes (12.13%) (range, 0–90 minutes). The average sleep latency time was 21.36 minutes (range, 0.5–138 minutes). The total apnea-hypopnea index (AHI) was 12.64/hour with 26 (40%) children having mild OSA, defined as an AHI of less than 5/hour; 17 (26.1%) having moderate OSA, defined as an AHI of 5 to 10/hour; 22 (33.8%) having severe OSA defined as an AHI of 15 to 30/hour. The mean REM AHI was 29.67/hour. Thirty-four children were started on bilevel positive airway pressure (BiPAP) following the study and four children had their BiPAP setting titrated following the study with one child whose high flow oxygen was continued. Conclusion Of the 65 pediatric sleep studies included, 39 children (60%) underwent some form of intervention following the study, indicating the clear benefit of performing polysomnography and indicating a high prevalence of sleep disorders in children. Mouth breathing was the most common symptom and OSA was the most common diagnosis. How to cite this article Kinimi I, Rao NM. Review of Pediatric Polysomnographic Studies over a 2-year Period in a Tertiary Care Hospital in Bengaluru, India. Indian J Sleep Med 2021;16(1):14–17.