Polysomnographic studies carried out in our sleep disorders unit in pediatric patients

Introduction The Sleep Respiratory Disorders Unit of adults are mainly focused on the study of Sleep Apnea Syndrome. In our Unit about 900 adult patients are studied per year, of which 75% are studied by conventional polysomnography (PSG). However, sleep studies in children are becoming more frequent as Pediatrics Services are not usually equipped with the necessary material to perform this type of tests. For this reason, pediatrics asks us for collaboration. The adult pulmonologists have to be familiar with the pediatric patient and we must bear in mind that the limits of normality and sleep patterns in the child differ from those of the adult.

Material and method Retrospective study of the last 3 years analyzing the results of 30 PSG performed in children. The data collected were: sex, age, primary pathology, Apnea Hypopnea Index (AHI), usual oxymetric parameters and hypnogram.

Results There were 30 children aged between 3 and 14 years. Of them only 4 have not become complete PSG. 20 had serious congenital diseases, 2 were obese, 1 hypertensive and 7 had no previous disease. 13 children had an AHI ≥ 3 (6 with AHI> 10). Of the 30, 14 of them reached SatO2 < 90% at some time during sleep although, with the exception of one patient, they maintained SatO2 averages > 90%. It was observed that the children had a hypnogram different from the usual one in adults, with a percentage of slow wave sleep (47% on average) higher than in adults. We did not make any therapeutic decision in the children who had a normal nocturnal study, in the “limit of normality” or with mild disorders, which were 24 of the 30 cases, while in the remaining 6 cases, in which more severe results were obtained, we decided, agreed with the pediatricians: establishment of CPAP in 4 cases and BiPAP in 2 cases, one of them with oxygen therapy.

Conclusions■

• Polysomnographic studies in children are < 1% of the total in our Sleep Disorder Unit.

• Most children suffered from a severe base pathology.

• A complete study was conducted in 26 of the 30 patients.

• Most studies were normal, were in the limit of normality or had mild respiratory disorders.

• Only 20% needed to start treatment with CPAP or BiPAP in consensus with their pediatrician.

• Adult pulmonologists should know the sleep pathology in children.