The role of sleep laboratory polygraphy in the evaluation of obstructive sleep apnea syndrome in Robin infants.

Infants Obstructive sleep apnea syndrome Polygraphy Polysomnography Respiratory management Robin sequence

Journal

Sleep medicine
ISSN: 1878-5506
Titre abrégé: Sleep Med
Pays: Netherlands
ID NLM: 100898759

Informations de publication

Date de publication:
08 2020
Historique:
received: 01 11 2019
revised: 28 02 2020
accepted: 02 03 2020
pubmed: 20 6 2020
medline: 22 6 2021
entrez: 20 6 2020
Statut: ppublish

Résumé

Currently, obstructive sleep apnea syndrome (OSAS) management in Robin sequence (RS) infants has not been standardized. Sleep laboratory polysomnography (PSG) is the gold standard for OSAS diagnosis, however, access is restricted. This study aimed to compare the respiratory indexes measured in a sleep laboratory using PSG as well as a possible alternative, polygraphy (PG). This retrospective study was conducted between 2015 and 2017 in a tertiary hospital. PSG performed in RS infants in the sleep laboratory was analysed by a single reviewer. After sleep data removal, anonymized raw data were analysed to obtain only PG data. Respiratory indexes were compared for (i) PSG and PG and (ii) patients with or without OSAS clinical signs. Among the 20 RS (median [IQR] age: 43 [25-114] days at evaluation), 70% of the patients had OSAS clinical signs but all of them had severe OSAS. The median mixed obstructive apnea hypopnea index was not significantly different between PSG and PG (27/h [18-38] versus 26/h [18-56], p = 0.43). The median obstructive apnea index was higher with no significant difference between PG and PSG (19/h [15-31] versus 7/h [4-25], p = 0.05). The median obstructive hypopnea index was significantly lower on PG than on PSG (2/h [0-3] versus 8/h [8-19], p = 0.01). No difference on PSG or PG was observed for patients with and without clinical signs of OSAS. Although PSG remains the gold standard for OSA evaluation, a PG seems to be a useful alternative to measure OSA in RS infants because of their OSAS severity. This evaluation should be recommended in all RS infants, even in the absence of OSAS clinical signs. Not applicable.

Sections du résumé

OBJECTIVE/BACKGROUND
Currently, obstructive sleep apnea syndrome (OSAS) management in Robin sequence (RS) infants has not been standardized. Sleep laboratory polysomnography (PSG) is the gold standard for OSAS diagnosis, however, access is restricted. This study aimed to compare the respiratory indexes measured in a sleep laboratory using PSG as well as a possible alternative, polygraphy (PG).
PATIENTS/METHODS
This retrospective study was conducted between 2015 and 2017 in a tertiary hospital. PSG performed in RS infants in the sleep laboratory was analysed by a single reviewer. After sleep data removal, anonymized raw data were analysed to obtain only PG data. Respiratory indexes were compared for (i) PSG and PG and (ii) patients with or without OSAS clinical signs.
RESULTS
Among the 20 RS (median [IQR] age: 43 [25-114] days at evaluation), 70% of the patients had OSAS clinical signs but all of them had severe OSAS. The median mixed obstructive apnea hypopnea index was not significantly different between PSG and PG (27/h [18-38] versus 26/h [18-56], p = 0.43). The median obstructive apnea index was higher with no significant difference between PG and PSG (19/h [15-31] versus 7/h [4-25], p = 0.05). The median obstructive hypopnea index was significantly lower on PG than on PSG (2/h [0-3] versus 8/h [8-19], p = 0.01). No difference on PSG or PG was observed for patients with and without clinical signs of OSAS.
CONCLUSION
Although PSG remains the gold standard for OSA evaluation, a PG seems to be a useful alternative to measure OSA in RS infants because of their OSAS severity. This evaluation should be recommended in all RS infants, even in the absence of OSAS clinical signs.
CLINICAL TRIAL REGISTRATION
Not applicable.

Identifiants

pubmed: 32554055
pii: S1389-9457(20)30112-X
doi: 10.1016/j.sleep.2020.03.003
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

59-64

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

L Coutier (L)

Service de pneumologie infantile, allergologie et centre de référence en mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France; Service d'épileptologie clinique, des troubles du sommeil et de neurologie fonctionnelle de l'enfant, Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France; INSERM, U1028, CNRS, UMR5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France. Electronic address: laurianne.coutier@chu-lyon.fr.

P Bierme (P)

Service de pneumologie infantile, allergologie et centre de référence en mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.

M Thieux (M)

Service d'épileptologie clinique, des troubles du sommeil et de neurologie fonctionnelle de l'enfant, Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France; INSERM, U1028, CNRS, UMR5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France.

A Guyon (A)

Service d'épileptologie clinique, des troubles du sommeil et de neurologie fonctionnelle de l'enfant, Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France; INSERM, U1028, CNRS, UMR5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France.

I Ioan (I)

Service d'explorations fonctionnelles pédiatriques, Hôpital d'Enfants, Centre Hospitalier Universitaire de Nancy, France.

P Reix (P)

Service de pneumologie infantile, allergologie et centre de référence en mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.

P Franco (P)

Service d'épileptologie clinique, des troubles du sommeil et de neurologie fonctionnelle de l'enfant, Hôpital Femme Mère Enfants, Hospices Civils de Lyon, Bron, France; INSERM, U1028, CNRS, UMR5292, Centre de Recherche en Neurosciences de Lyon, Lyon, France.

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Classifications MeSH