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Inicio Acta Otorrinolaringológica Española Clinical and Polysomnographic Correlation in Sleep-related Breathing Disorders i...
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Vol. 64. Issue 2.
Pages 108-114 (March - April 2013)
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Vol. 64. Issue 2.
Pages 108-114 (March - April 2013)
Original Article
Clinical and Polysomnographic Correlation in Sleep-related Breathing Disorders in Children
Correlación entre la clínica y la polisomnografía en los trastornos respiratorios del sueño infantil
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Eduard Estellera,
Corresponding author
eesteller@gmail.com

Corresponding author.
, Paola Santosa, Francesc Segarrab, Eduard Estivillb, Roser Lopeza, Eusebi Matiñóa, Joan Manel Ademàa
a Servicio de Otorrinolaringología, Hospital General de Catalunya, San Cugat del Vallès, Barcelona, Spain
b Unidad del Sueño, Hospital General de Catalunya, San Cugat del Vallès, Barcelona, Spain
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Figures (1)
Tables (3)
Table 1. Population of 170 Children With Symptoms of SDB Before the Surgery.
Table 2. Evolution of Clinical Data and AHI in 80 Children Monitored 1 Year After Adenotonsillectomy.
Table 3. Evolution of Clinical Data of the 80 Cases Monitored After Surgery Compared According to Persistence or Resolution of the Disease.
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Abstract
Introduction

Although polysomnography is the gold standard test for sleep-disordered breathing in children, there is controversy about its indication in all cases. Among the arguments both for and against is the lack of correlation between objective values and the symptoms.

Objective

To evaluate the correlation between clinical data and apnea–hypopnoea index (AHI) in our work environment.

Material and methods

We compared the preoperative clinical symptoms and AHI statistically in 170 children with sleep-disordered breathing who underwent polysomnography. We also analysed the correlation to postoperative level, with a subgroup of 80 children who underwent adenotonsillectomy with 1 year of polysomnography follow-up.

Results

Before surgery, only the degree of tonsillar hypertrophy was statistically significant correlated with AHI. At post-operative follow-up, evidence of correlation between AHI and apnoea was observed: 38.1% of children improved in the group with persistence and 66.7% in the disease resolution group (P=.023). In addition, the correlations showed the level of improvement of snoring, as assessed by visual analogue scale. The mean was 5 points lower in the persistent group and 6.1 lower in the disease resolution group (P=.047).

Conclusion

Despite the limitations in the correlation between clinical data and polysomnography, especially in preoperative results, polysomnography remains the gold standard diagnostic tool. Efforts should be made to obtain objective parameters that provide higher levels of correlation.

Keywords:
Sleep-related breathing disorders in children
Nocturnal polysomnography
Obstructive sleep apnoea syndrome in children
Apnea–hypopnoea index
Resumen
Introducción

A pesar de que la polisomnografía supone la prueba diagnóstica por excelencia de los trastornos respiratorios del sueño en niños, existe controversia sobre su indicación en todos los casos. De entre los argumentos utilizados, tanto a favour como en contra, se encuentra la falta de correlación existente entre sus valores objetivos y la sintomatología.

Objetivo

Evaluar la correlación entre los datos clínicos y el índice de apnea–hipoapnea (IAH), en nuestro entorno de trabajo.

Material y método

Se compara estadísticamente la clínica preoperatoria y el IAH de 170 niños con trastorno respiratorio del sueño, sometidos a polisomnografia. También se evalúa la correlación a nivel postoperatorio, con un subgrupo de 80 niños intervenidos de adenoamigdalectomía con seguimiento polisomnográfico a un año.

Resultados

A nivel preoperatorio únicamente el grado de hipertrofia amigdalar mostró correlación significativa con el IAH. A nivel postoperatorio se evidencia una correlación entre el IAH y las apneas observadas: 38,1% de los niños mejoran según los padres en el grupo con persistencia polisomnográfica y el 66,7% en el grupo con resolución de la enfermedad (p=0,023). También muestra correlación el nivel de mejora del ronquido, valorado mediante escala analógica visual. La media bajó 5 puntos en el grupo persistente y 6,1 en el grupo con resolución de la enfermedad (p=0,047).

Conclusión

A pesar de las limitaciones en la correlación entre la clínica y la polisomnografia, especialmente en el preoperatorio, la prueba objetiva por excelencia sigue siendo esta. Deben hacerse esfuerzos para conseguir parámetros objetivos que aporten mayor nivel de correlación.

Palabras clave:
Trastornos respiratorios del sueño infantil
Polisomnografía nocturna
Síndrome de apnea obstructiva del sueño infantil
Índice de apnea–hipoapnea

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