Chest
Clinical Investigations: Sleep and BreathingShould Children With Suspected Obstructive Sleep Apnea Syndrome And Normal Nap Sleep Studies Have Overnight Sleep Studies?
Section snippets
Patients
All patients were referred for polysomnography by their physicians for the evaluation of OSAS secondary to adenotonsillar hypertrophy. The study was confined to children with adenotonsillar hypertrophy because they comprise the majority of children undergoing polysomnography in pediatric sleep laboratories, and they were otherwise healthy, and did not have complicating medical conditions. All the subjects had a nap study with either normal or mildly abnormal findings, and were referred back for
Results
One hundred forty-three children had normal or mildly abnormal findings on nap PSGs from 1991 to 1998. Their mean age was 5.6 ± 3.1 years, and 52 were girls (36%). The mean interval between nap and overnight PSGs was 5.9 ± 4.8 months. Total sleep time during nap studies was 1 h, while mean sleep time during the overnight studies was 5.1 ± 1.3 h.
One hundred thirty-eight patients (96%) were sedated with chloral hydrate during nap studies. The remaining patients did not receive chloral hydrate
Discussion
We found that no individual nap study parameter was very sensitive in predicting the presence of obstructive sleep apnea in an overnight sleep study. However, many of them had good specificity and positive predictive values. We also found that if nap studies are even mildly abnormal, there is a high chance of having an abnormal overnight sleep study. This study also suggests that nap studies underestimate the abnormalities detected by ONP, even when children were sedated with chloral hydrate.
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Cited by (71)
Obstructive sleep apnea in children
2023, Encyclopedia of Sleep and Circadian Rhythms: Volume 1-6, Second EditionObstructive events in children with Prader–Willi syndrome occur predominantly during rapid eye movement sleep
2019, Sleep MedicineCitation Excerpt :In most typically developing children, OSAS is a REM-related breathing disorder [16–18]. Hence, adequate sleep duration during polysomnography is necessary to avoid underestimation of OSAS severity, as it can occur with daytime nap studies, which may not include REM sleep periods [19]. We have hypothesized that children with PWS are more prone to obstructive events during REM sleep even before treatment with growth hormone than typically developing children with OSAS caused by adenotonsillar hypertrophy and/or obesity.
Sleep study as a diagnostic tool for unexplained respiratory failure in infants hospitalized in the PICU
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2016, Otolaryngologic Clinics of North AmericaCitation Excerpt :PPV of 77% to 100% NPV of 17% to 70% to 17%23,24 Nap PSG is not recommended for the definitive diagnosis of OSA by either the American Academy of Sleep Medicine or the American Academy of Pediatrics, because it can underestimate the presence or severity of OSA compared with in-laboratory nocturnal PSG.
Diagnosis of Obstructive Sleep Apnea
2012, Principles and Practice of Pediatric Sleep Medicine: Second Edition