Original Articles
Reliability of Respiratory Polygraphy for the Diagnosis of Sleep Apnea-Hypopnea Syndrome in Children
María Luz Alonso Álvareza,b,
, Joaquín Terán Santosa,b, José Aurelio Cordero Guevaraa,b, Ana Isabel Navazo Egüiaa,b, Estrella Ordax Carbajoa,b, Juan Fernando Masa Jiménezb,c, Rafael Pelayod
Corresponding author
mari63@separ.es
Correspondence: Dr M.L. Alonso Álvarez Unidad de Trastornos Respiratorios del Sueño Servicio de Neumología, Complejo Asistencial de Burgos Avda del Cid, 9609005 Burgos, Spain
Correspondence: Dr M.L. Alonso Álvarez Unidad de Trastornos Respiratorios del Sueño Servicio de Neumología, Complejo Asistencial de Burgos Avda del Cid, 9609005 Burgos, Spain
a Unidad de Trastornos Respiratorios del Sueño, Sección de Neumología, Complejo Asistencial de Burgos, Burgos, Spain
b CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
c Servicio de Neumología, Hospital San Pedro de Alcántara, Cáceres, Spain
d Department of Psychiatry and Behavioral Science, Stanford University, Stanford, California, USARafael Pelayo holds a grant from the Spanish Society for Pulmonology and Thoracic Surgery (SEPAR)
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"entidad" => "Unidad de Trastornos Respiratorios del Sueño, Sección de Neumología, Complejo Asistencial de Burgos, Burgos, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Neumología, Hospital San Pedro de Alcántara, Cáceres, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Department of Psychiatry and Behavioral Science, Stanford University, Stanford, California, USARafael Pelayo holds a grant from the Spanish Society for Pulmonology and Thoracic Surgery (SEPAR)" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr M.L. Alonso Álvarez Unidad de Trastornos Respiratorios del Sueño Servicio de Neumología, Complejo Asistencial de Burgos Avda del Cid, 9609005 Burgos, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-02-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155277" "palabras" => array:6 [ 0 => "Sleep-disordered breathing" 1 => "Children" 2 => "Sleep" 3 => "Obstructive sleep apnea" 4 => "Apnea" 5 => "Sleep studies" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155276" "palabras" => array:6 [ 0 => "Trastornos respiratorios del sueño" 1 => "Niños" 2 => "Sueño" 3 => "Apnea obstructiva del sueño" 4 => "Apnea" 5 => "Estudios de sueño" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Overnight polysomnography (PSG) is thegold standard diagnostic tool for sleep apnea-hypopneasyndrome (SAHS) in children. The aim of the present studywas to evaluate the usefulness of diagnostic respiratorypolygraphy in children with clinically suspected SAHSreferred to our sleep-disordered breathing clinic.</p> <span class="elsevierStyleSectionTitle">Patients and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We studied 53 children referredwith clinical suspicion of SAHS; 29 (54.7%) were boys andthe mean (SD) age was 6.4 (2.9) years. After a medicalhistory was taken and a physical examination performed, patients underwent respiratory polygraphy (Edentec)simultaneously with overnight PSG in the sleep laboratory. The 2 diagnostic tools were compared using statisticalanalysis.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">SAHS was defined by an obstructive apnea-hypopnea index (OAHI) of 3 or more in overnight PSG anda respiratory disturbance index (RDI) of 3 or more inrespiratory polygraphy. The rate of diagnostic agreementwas 84.9%. The difference between the mean OAHI andRDI values was not significant (0.7 [5.4]; <span class="elsevierStyleItalic">P</span> =.34). Theintraclass correlation coefficient between the OAHI andRDI was 89.4 (95% confidence interval, 82.4-93.7; <span class="elsevierStyleItalic">P</span> <.001).</p><p class="elsevierStyleSimplePara elsevierViewall">When receiver operating characteristic curves werecalculated for the OAHI cutoff points used for the diagnosisof SAHS (1, 3, and 5), the best RDI cutoff for all 3 OAHI valuesconsidered was found to be 4.6. When age strata wereconsidered, in children 6 years or older the best RDI cutofffor the 3 OAHI values was 2.1. In children younger than 6 years the best RDI cutoff was 3.35 for OAHI 1 and 5.85 forOAHI 3 and 5.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Respiratory polygraphy in the sleeplaboratory is a valid method for the diagnosis of SAHS inchildren.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La polisomnografía (PSG) nocturna es la técni-ca diagnóstica de referencia del síndrome de apneas-hipop-neas durante el sueño (SAHS) en niños. El objetivo del estu-dio ha sido evaluar la utilidad diagnóstica de la poligrafíarespiratoria (PR) en niños con sospecha clínica de SAHS re-mitidos a la Unidad de Trastornos Respiratorios del Sueño.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudió a 53 niños remitidos porsospecha clínica de SAHS (29 varones; 54,7%), con unaedad media ± desviación estándar de 6,4 ± 2,9 años. A todosellos se les realizaron historia clínica, exploración física, PR(Edentec®) y PSG nocturna simultáneamente en el labora-torio de sueño. Se realizó el análisis estadístico para compa-rar ambas técnicas diagnósticas.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Definiendo el diagnóstico de SAHS como lapresencia de un índice de apneas-hipopneas obstructivas(IAHO) igual o mayor de 3 en la PSG y un índice de eventosrespiratorios (IER) de 3 o superior en la PR, la coincidenciadiagnóstica fue del 84,9%. La diferencia de medias entre elIAHO y el IER no fue significativa (0,7 ± 5,4; p = 0,34). Elcoeficiente de correlación intraclase entre el IAHO y el IERfue de de 89,4 (intervalo de confianza del 95%, 82,4-93,7; p < 0,001).</p><p class="elsevierStyleSimplePara elsevierViewall">Para el diagnóstico de SAHS se consideraron los valoresde IAHO iguales o mayores de 1; iguales o mayores de 3, eiguales o mayores de 5. Se calcularon las curvas de eficaciadiagnóstica para cada uno de ellos y 4,6 resultó ser el mejorIER para los 3 valores de IAHO considerados. Al analizarpor estratos de edad, en niños de 6 años o más el mejor IERobtenido para los 3 valores de IAHO considerados fue 2,1.En niños menores de 6 años se obtuvieron los siguientes va-lores de IER: 3,35 para IAHO de 1 o superior y 5,85 paraIAHO de 3 o mayor y de 5 o superior.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La PR realizada en el laboratorio de sue-ño es un método válido para el diagnóstico de SAHS en ni-ños.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "American Academy of Pediatrics. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 3 | 5 |
| 2024 October | 28 | 15 | 43 |
| 2024 September | 30 | 20 | 50 |
| 2024 August | 34 | 34 | 68 |
| 2024 July | 26 | 27 | 53 |
| 2024 June | 36 | 33 | 69 |
| 2024 May | 43 | 41 | 84 |
| 2024 April | 19 | 25 | 44 |
| 2024 March | 21 | 17 | 38 |
| 2024 February | 22 | 17 | 39 |
| 2023 March | 2 | 4 | 6 |
| 2023 February | 20 | 19 | 39 |
| 2023 January | 16 | 25 | 41 |
| 2022 December | 16 | 25 | 41 |
| 2022 November | 25 | 17 | 42 |
| 2022 October | 21 | 25 | 46 |
| 2022 September | 11 | 20 | 31 |
| 2022 August | 22 | 29 | 51 |
| 2022 July | 21 | 43 | 64 |
| 2022 June | 15 | 30 | 45 |
| 2022 May | 21 | 25 | 46 |
| 2022 April | 16 | 27 | 43 |
| 2022 March | 19 | 40 | 59 |
| 2022 February | 18 | 21 | 39 |
| 2022 January | 15 | 26 | 41 |
| 2021 December | 14 | 45 | 59 |
| 2021 November | 20 | 48 | 68 |
| 2021 October | 17 | 49 | 66 |
| 2021 September | 16 | 57 | 73 |
| 2021 August | 10 | 37 | 47 |
| 2021 July | 9 | 26 | 35 |
| 2021 June | 15 | 38 | 53 |
| 2021 May | 25 | 30 | 55 |
| 2021 April | 35 | 67 | 102 |
| 2021 March | 23 | 27 | 50 |
| 2021 February | 15 | 24 | 39 |
| 2021 January | 14 | 14 | 28 |
| 2020 December | 14 | 21 | 35 |
| 2020 November | 19 | 10 | 29 |
| 2020 October | 9 | 8 | 17 |
| 2020 September | 11 | 4 | 15 |
| 2020 August | 8 | 14 | 22 |
| 2020 July | 17 | 22 | 39 |
| 2020 June | 20 | 5 | 25 |
| 2020 May | 13 | 10 | 23 |
| 2020 April | 24 | 26 | 50 |
| 2020 March | 14 | 9 | 23 |
| 2020 February | 21 | 15 | 36 |
| 2020 January | 14 | 21 | 35 |
| 2019 December | 15 | 22 | 37 |
| 2019 November | 14 | 11 | 25 |
| 2019 October | 11 | 12 | 23 |
| 2019 September | 3 | 8 | 11 |
| 2019 August | 6 | 10 | 16 |
| 2019 July | 16 | 15 | 31 |
| 2019 June | 7 | 14 | 21 |
| 2019 May | 17 | 20 | 37 |
| 2019 April | 32 | 33 | 65 |
| 2019 March | 16 | 25 | 41 |
| 2019 February | 10 | 12 | 22 |
| 2019 January | 6 | 10 | 16 |
| 2018 December | 9 | 14 | 23 |
| 2018 November | 22 | 22 | 44 |
| 2018 October | 28 | 17 | 45 |
| 2018 September | 12 | 9 | 21 |
| 2018 May | 4 | 0 | 4 |
| 2018 April | 11 | 11 | 22 |
| 2018 March | 10 | 7 | 17 |
| 2018 February | 5 | 8 | 13 |
| 2018 January | 10 | 8 | 18 |
| 2017 December | 8 | 6 | 14 |
| 2017 November | 3 | 7 | 10 |
| 2017 October | 9 | 8 | 17 |
| 2017 September | 5 | 9 | 14 |
| 2017 August | 9 | 9 | 18 |
| 2017 July | 15 | 18 | 33 |
| 2017 June | 12 | 29 | 41 |
| 2017 May | 4 | 9 | 13 |
| 2017 April | 4 | 14 | 18 |
| 2017 March | 4 | 4 | 8 |
| 2017 February | 3 | 9 | 12 |
| 2017 January | 1 | 3 | 4 |
| 2016 December | 10 | 7 | 17 |
| 2016 November | 8 | 10 | 18 |
| 2016 October | 8 | 10 | 18 |
| 2016 September | 9 | 9 | 18 |
| 2016 August | 7 | 3 | 10 |
| 2016 July | 11 | 5 | 16 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 54 | 10 | 64 |
| 2015 September | 39 | 9 | 48 |
| 2015 August | 45 | 8 | 53 |
| 2015 July | 59 | 12 | 71 |
| 2015 June | 24 | 5 | 29 |
| 2015 May | 67 | 7 | 74 |
| 2015 April | 54 | 14 | 68 |
| 2015 March | 44 | 4 | 48 |
| 2015 February | 43 | 7 | 50 |
| 2015 January | 35 | 13 | 48 |
| 2014 December | 35 | 5 | 40 |
| 2014 November | 44 | 8 | 52 |
| 2014 October | 55 | 10 | 65 |
| 2014 September | 55 | 12 | 67 |
| 2014 August | 53 | 15 | 68 |
| 2014 July | 36 | 9 | 45 |
| 2014 June | 47 | 14 | 61 |
| 2014 May | 53 | 14 | 67 |
| 2014 April | 51 | 9 | 60 |
| 2014 March | 74 | 13 | 87 |
| 2014 February | 60 | 17 | 77 |
| 2014 January | 44 | 12 | 56 |
| 2013 December | 55 | 12 | 67 |
| 2013 November | 35 | 6 | 41 |
| 2013 October | 46 | 9 | 55 |
| 2013 September | 53 | 11 | 64 |
| 2013 August | 42 | 6 | 48 |
| 2013 July | 53 | 18 | 71 |
| 2013 June | 43 | 9 | 52 |
| 2013 May | 41 | 12 | 53 |
| 2013 April | 20 | 4 | 24 |
| 2013 March | 12 | 2 | 14 |
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