© Borgis - New Medicine 3/2012, s. 66-67
Alicja Sapała-Smoczyńska1, *Teresa Jackowska1,2
Accordance of clinical symptoms of OSAS (obstructive sleep apnea syndrome) with polisomnography results
1Department of Pediatrics, Bielanski Hospital, Warsaw
Head of Department: prof. Teresa Jackowska, MD, PhD
2Department of Pediatrics, The Medical Centre of Postgraduate Education, Warsaw
Head of Department: prof. Teresa Jackowska, MD, PhD
Summary
Introduction. OSAS is characterized by symptoms that occur during the day and night, such as snoring, sleep apnea, tiredness, drowsiness and behavioral disorders. A gold standard in diagnosing OSAS is polysomnography.
Aim. This study aims to compare the accordance of suspicion of OSAS posed by primary care physicians based on an interview and a physical examination with polysomnography results.
Material and methods. 66 children (43 males and 23 females), aged from 5 months to 16 years were hospitalized at the Department of Pediatrics (September 2009 to August 2011). Polysomnography was performed in Sleep Lab with the Elmico EEG DiGi Track device, with software extended for PSG.
Results. 24 patients (36%) met the criteria of OSAS. Among the children studied, in 8 (12%) cases we diagnosed a clinically significant central apnea, and in 13 patients (19.6%), the syndrome of an increased airway resistance was found. Altogether, in 45 children (68.2%) abnormalities in the PSG were observed, and in 21 children (31.8%) the examination showed no abnormalities.
Conclusions. A diagnosis of OSAS enables its treatment, and thereby prevents the related diseases and disorders such as hypertension, nocturia, obesity or behavioral disorders. Based on the results, where the compatibility of the symptoms with the results of PSG was observed in 36% cases, we are certain that the benefits of performing PSG for patients are rational, despite the occasional unjustifiable referrals for the test.
INTRODUCTION
Breathing disorders during sleep among children (1), (2), are primarily a problem of snoring children, dominated by patients with hypertrophy of lymphatic tissue of throat. The narrowing of the upper airways associated with hypertrophy may be the cause of snoring as well as pauses in breathing (Obstructive Sleep Apnea, OSA), whose presence in many cases allows the diagnosis of Obstructive Sleep Apnea Syndrome (OSAS).
An untreated OSAS may lead to disturbances in the child’s development and, as in adults, the development of a systemic hypertension and pulmonary hypertension (4), somnolence (5, 6), nocturnal enuresis (7, 8), obesity and the metabolic syndrome related to it (9, 10).
From a clinical perspective, the OSAS is characterized by the presence of day and night symptoms, such as the above mentioned snoring, apnea during sleep, sleepiness, behavioral disorders, hyperactivity and problems with concentration. Depending on the age of the patient, these symptoms may be noticed by the child itself, by the parents or by doctors of the Primary Health Care. In order to clearly explain the cause of the distressing symptoms, General Practitioners (GPs) have the option to refer for polysomnography (PSG), which is the gold standard in the diagnosis of OSAS and other breathing problems during sleep (SBD, Sleep Disorders of Breathing) (11).
The aim of this study was to assess how often the OSAS was diagnosed using PSG among children referred by GPs on the basis of the observed clinical symptoms.
MATERIAL AND METHODS
Polisomnographic studies of 66 patients aged 5 months to 16 years were analyzed (43 boys and 23 girls). Every PSG was performed at the Department of Pediatrics, Bielanski Hospital, Warsaw, in the period between September 2009 to August 2011 (2 years). Every patient was referred for PSG by a GP because of day or night symptoms.
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Piśmiennictwo
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