The reliability of polygraphy for the diagnosis of sleep disordered breathing in children

Abstract

<b>Introduction:</b> Polygraphy (PG) is easy available and can be applied at home as a screening test for diagnosis of sleep disordered breathing (SDB). <b>Aims:</b> To investigate reliability of all parameters of PG in pediatric patients undergoing Polysomnography (PSG). <b>Material and method:</b> All children with a suspected SDB who were evaluated with both PSG and PG were included. Patients’ ages, apnea-hypopnea index (AHI), obstructive apnea index (OAI), central apnea index (CAI), mixed apnea index (MAI), hypopnea index (HI), and oxygen desaturation index (ODI) in both PSG and PG were compared. <b>Results:</b> The median age of all 45 patients was 9.5 (IQR:6.4-13.2) years. 32 patients had a disease accompanying SDB such as chronic respiratory, neurological, rheumatological, hematological and endocrinological diseases. The median of AHI, OAI, CAI, MAI, HI and ODI were 3.4 (IQR:1.9-13.0), 0.9 (IQR:0-3.3), 1.0 (IQR:0.1-2.6), 0 (IQR:0-0.11), 0.5 (IQR:0.1-2.0) and 2.7 (IQR:0.9-9.8) in PSG, respectively. The median of AHI, OAI, CAI, MAI, HI and ODI were 4.4 (IQR:1.7-7.1), 0.3 (IQR:0.1-1.6), 1.1 (IQR:0.1-2.4), 0 (IQR:0-0), 0.8 (IQR:0.4-4.3) and 3.7 (IQR:1.7-10.0) in PG, respectively. There were strong positive correlations in AHI (r=0.860, p=0.001), OAI (r=0.910, p=0.001), HI (r=0.700, p=0.001) and ODI (r=0.750, p=0.001) results in PSG and PG. According to AHI, sensitivity, specificity, positive predictive and negative predictive value of PG were 94.6%, 37.5%, 87.5% and 60.0%, respectively. Diagnostic accuracy for SDB of PG was 82.0%. <b>Conclusions:</b> Although PSG is gold standard test, PG could be used safely in diagnosis of SDB in children with underlying diseases as a reliable alternative when PSG is not available.