Indian Journal of Sleep Medicine

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VOLUME 16 , ISSUE 1 ( January-March, 2021 ) > List of Articles

Original Article

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

Ilin Kinimi, Neha Mohan Rao

Keywords : Sleep disorders, Sleep study,Polysomnograph

Citation Information : Kinimi I, Rao NM. Review of Pediatric Polysomnographic Studies over a 2-year Period in a Tertiary Care Hospital in Bengaluru, India. Indian Sleep Med 2021; 16 (1):14-17.

DOI: 10.5005/jp-journals-10069-0066

License: CC BY-NC 4.0

Published Online: 00-03-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


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.


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  1. Dewald JF, Meijer AM, Oort FJ, et al. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: a meta-analytic review. Sleep Med Rev 2010;14:179–189. DOI: 10.1016/j.smrv.2009.10.004.
  2. Beck SE, Marcus CL. Pediatric polysomnography. Sleep Med Clin 2009;4(3):393–406. DOI: 10.1016/j.jsmc.2009.04.007.
  3. Indian Society for Sleep Research (ISSR) Newsletter, Issue: 2; Nov 1, 2015.
  4. Wilmott RW, Deterding RR, Li A, et al. Kendig's disorders of the respiratory tract in children. 9th ed. Elsevier; 2019. p. 1152.
  5. Tan YH, How CH, Chan YH, et al. Approach to the snoring child. Singapore Med J 2020;61(4):170–175. DOI: 10.11622/smedj.2020054.
  6. Berry RB, Budhiraja R, Gottleib DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. J Clin Sleep Med 2012;8(5):597–619. DOI: 10.5664/jcsm.2172.
  7. Carter B, Rees P, Hale L, et al. Association between portable screen-based media device access or use and sleep outcomes: a systematic review and meta-analysis. JAMA Pediatr 2016;170(12):1202–1208. DOI: 10.1001/jamapediatrics.2016.2341.
  8. Narasimhan U, Anitha FS, Anbu C, et al. The spectrum of sleep disorders among children: a cross-sectional study at a south-Indian tertiary care hospital. Cureus 2020;12(4):e7535. DOI: 10.7759/cureus.7535.
  9. Jacob SV, Morielli A, Mograss MA, et al. Home testing for pediatric obstructive sleep apnea syndrome secondary to adenotonsillar hypertrophy. Pediatr Pulmonol 1995;20(4):241–252. DOI: 10.1002/ppul.1950200407.
  10. Poels PJ, Schilder AG, van den BS, et al. Evaluation of a new device for home cardiorespiratory recording in children. Arch Otolaryngol Head Neck Surg 2003;129(12):1281–1284. DOI: 10.1001/archotol.129.12.1281.
  11. Goodwin JL, Enright PL, Kaemingk KL, et al. Feasibility of using unattended polysomnography in children for research--report of the Tucson Children's Assessment of Sleep Apnoea study (TuCASA). Sleep 2001;24(8):937–944. DOI: 10.1093/sleep/24.8.937.
  12. Brockmann PE, Schaefer C, Poets A, et al. Diagnosis of obstructive sleep apnoea in children: a systematic review. Sleep Med Rev 2013;17(5):331–340. DOI: 10.1016/j.smrv.2012.08.004.
  13. Jain S, Bhatt GC, Goya A, et al. Obstructive sleep apnoea in children with nocturnal enuresis. Indian Pediatr 2018;55(5):433–434.
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