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VOLUME 31, ISSUE 12

PSG RESPIRATORY SCORING IN ADOLESCENTS
Polysomnographic Values In Children Undergoing Puberty: Pediatric Vs. Adult Respiratory Rules in Adolescents

Ignacio E. Tapia, MD1; Laurie Karamessinis, CCRC1; Preetam Bandla, MD1; Jingtao Huang, PhD1; Andrea Kelly, MD2; Michelle Pepe, RPSGT1; Brian Schultz, RPSGT1; Paul Gallagher, MA3; Lee J. Brooks, MD1; Carole L. Marcus, MBBCh1

1Sleep Center, 2Division of Endocrinology, and 3Division of Biostatistics and Epidemiology, The Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA



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Study Objectives:

Polysomnographic respiratory events in children should be scored using pediatric respiratory rules. However, due to a lack of data on adolescents, recently revised rules allow children aged 13–18 years to be scored by adult or pediatric criteria. To clarify which criteria to use, we describe the evolution of respiratory events with Tanner stage, and we compare events in children aged 13–18 years with the new American Academy of Sleep Medicine adult and pediatric respiratory rules.

Design:

Cross-sectional

Setting:

Academic hospital

Participants:

Healthy subjects aged 8–18 years recruited for research purposes

Interventions:

Physical examination to determine Tanner stage, overnight polysomnogram, and determination of sex hormones.

Results:

Sixty-eight subjects (Tanner 1–5) were studied, mean age [SD] = 13 ± 3 years, median apnea hypopnea index (AHI) = 0.1 (range: 0–1.2)/h. The median percentages of total sleep time (TST) with SpO2 < 92% were 0.1 (0–4.2)%, and with end-tidal CO2 > 50 torr was 0.1 (0–88.6)%. Thirty-two subjects were aged 13–18 years, (Tanner 3–5). The difference between AHI scored by pediatric (median = 0 [0–0.9]/h) and adult (median = 0 [0 – 0.5]/h) criteria was statistically significant (P = 0.043), but not clinically relevant.

Conclusions:

Respiratory events in normal children aged 8–18 years are rare and unrelated to Tanner stage. Adult or pediatric respiratory rules can be used for scoring polysomnograms in asymptomatic subjects approaching adulthood. Further studies are needed in symptomatic children within this age group.

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