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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Overnight polysomnography &#40;PSG&#41; is thegold standard diagnostic tool for sleep apnea-hypopneasyndrome &#40;SAHS&#41; in children&#46; 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&#46;</p> <span class="elsevierStyleSectionTitle">Patients and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We studied 53 children referredwith clinical suspicion of SAHS&#59; 29 &#40;54&#46;7&#37;&#41; were boys andthe mean &#40;SD&#41; age was 6&#46;4 &#40;2&#46;9&#41; years&#46; After a medicalhistory was taken and a physical examination performed&#44; patients underwent respiratory polygraphy &#40;Edentec&#41;simultaneously with overnight PSG in the sleep laboratory&#46; The 2 diagnostic tools were compared using statisticalanalysis&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">SAHS was defined by an obstructive apnea-hypopnea index &#40;OAHI&#41; of 3 or more in overnight PSG anda respiratory disturbance index &#40;RDI&#41; of 3 or more inrespiratory polygraphy&#46; The rate of diagnostic agreementwas 84&#46;9&#37;&#46; The difference between the mean OAHI andRDI values was not significant &#40;0&#46;7 &#91;5&#46;4&#93;&#59; <span class="elsevierStyleItalic">P</span> &#61;&#46;34&#41;&#46; Theintraclass correlation coefficient between the OAHI andRDI was 89&#46;4 &#40;95&#37; confidence interval&#44; 82&#46;4-93&#46;7&#59; <span class="elsevierStyleItalic">P</span> &#60;&#46;001&#41;&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">When receiver operating characteristic curves werecalculated for the OAHI cutoff points used for the diagnosisof SAHS &#40;1&#44; 3&#44; and 5&#41;&#44; the best RDI cutoff for all 3 OAHI valuesconsidered was found to be 4&#46;6&#46; When age strata wereconsidered&#44; in children 6 years or older the best RDI cutofffor the 3 OAHI values was 2&#46;1&#46; In children younger than 6 years the best RDI cutoff was 3&#46;35 for OAHI 1 and 5&#46;85 forOAHI 3 and 5&#46;</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&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La polisomnograf&#237;a &#40;PSG&#41; nocturna es la t&#233;cni-ca diagn&#243;stica de referencia del s&#237;ndrome de apneas-hipop-neas durante el sue&#241;o &#40;SAHS&#41; en ni&#241;os&#46; El objetivo del estu-dio ha sido evaluar la utilidad diagn&#243;stica de la poligraf&#237;arespiratoria &#40;PR&#41; en ni&#241;os con sospecha cl&#237;nica de SAHS re-mitidos a la Unidad de Trastornos Respiratorios del Sue&#241;o&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudi&#243; a 53 ni&#241;os remitidos porsospecha cl&#237;nica de SAHS &#40;29 varones&#59; 54&#44;7&#37;&#41;&#44; con unaedad media &#177; desviaci&#243;n est&#225;ndar de 6&#44;4 &#177; 2&#44;9 a&#241;os&#46; A todosellos se les realizaron historia cl&#237;nica&#44; exploraci&#243;n f&#237;sica&#44; PR&#40;Edentec&#174;&#41; y PSG nocturna simult&#225;neamente en el labora-torio de sue&#241;o&#46; Se realiz&#243; el an&#225;lisis estad&#237;stico para compa-rar ambas t&#233;cnicas diagn&#243;sticas&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Definiendo el diagn&#243;stico de SAHS como lapresencia de un &#237;ndice de apneas-hipopneas obstructivas&#40;IAHO&#41; igual o mayor de 3 en la PSG y un &#237;ndice de eventosrespiratorios &#40;IER&#41; de 3 o superior en la PR&#44; la coincidenciadiagn&#243;stica fue del 84&#44;9&#37;&#46; La diferencia de medias entre elIAHO y el IER no fue significativa &#40;0&#44;7 &#177; 5&#44;4&#59; p &#61; 0&#44;34&#41;&#46; Elcoeficiente de correlaci&#243;n intraclase entre el IAHO y el IERfue de de 89&#44;4 &#40;intervalo de confianza del 95&#37;&#44; 82&#44;4-93&#44;7&#59; p &#60; 0&#44;001&#41;&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Para el diagn&#243;stico de SAHS se consideraron los valoresde IAHO iguales o mayores de 1&#59; iguales o mayores de 3&#44; eiguales o mayores de 5&#46; Se calcularon las curvas de eficaciadiagn&#243;stica para cada uno de ellos y 4&#44;6 result&#243; ser el mejorIER para los 3 valores de IAHO considerados&#46; Al analizarpor estratos de edad&#44; en ni&#241;os de 6 a&#241;os o m&#225;s el mejor IERobtenido para los 3 valores de IAHO considerados fue 2&#44;1&#46;En ni&#241;os menores de 6 a&#241;os se obtuvieron los siguientes va-lores de IER&#58; 3&#44;35 para IAHO de 1 o superior y 5&#44;85 paraIAHO de 3 o mayor y de 5 o superior&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La PR realizada en el laboratorio de sue-&#241;o es un m&#233;todo v&#225;lido para el diagn&#243;stico de SAHS en ni-&#241;os&#46;</p>"
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Vol. 44. Issue 6.
Pages 318-323 (January 2008)
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Vol. 44. Issue 6.
Pages 318-323 (January 2008)
Original Articles
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Reliability of Respiratory Polygraphy for the Diagnosis of Sleep Apnea-Hypopnea Syndrome in Children
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María Luz Alonso Álvareza,b,
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
, 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
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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Article information
Objective

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.

Patients and Methods

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.

Results

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]; P =.34). Theintraclass correlation coefficient between the OAHI andRDI was 89.4 (95% confidence interval, 82.4-93.7; P <.001).

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.

Conclusions

Respiratory polygraphy in the sleeplaboratory is a valid method for the diagnosis of SAHS inchildren.

Key words:
Sleep-disordered breathing
Children
Sleep
Obstructive sleep apnea
Apnea
Sleep studies
Objetivo

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.

Pacientes y métodos

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.

Resultados

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).

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.

Conclusiones

La PR realizada en el laboratorio de sue-ño es un método válido para el diagnóstico de SAHS en ni-ños.

Palabras clave:
Trastornos respiratorios del sueño
Niños
Sueño
Apnea obstructiva del sueño
Apnea
Estudios de sueño
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Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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