TY - JOUR
T1 - Use of the sleep clinical record in the follow-up of children with obstructive sleep apnea (OSA) after treatment
AU - Villa, Maria Pia
AU - Sujanska, Anna
AU - Vitelli, Ottavio
AU - Evangelisti, Melania
AU - Rabasco, Jole
AU - Pietropaoli, Nicoletta
AU - Banovcin, Peter
AU - Kheirandish-Gozal, Leila
AU - Gozal, David
N1 - Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Purpose: The aim of our study was to evaluate the utility of the sleep clinical record (SCR) in the follow-up of children with obstructive sleep apnea (OSA) after treatment. Methods: SCR was completed and overnight polysomnography (PSG) was performed in all enrolled children (T0), with SCR considered positive for scores ≥6.5, as previously validated. Patients underwent adenotonsillectomy (T&A), rapid maxillary expansion (RME), and medical therapy according to severity of OSA and clinical features. Six months after completing therapy, the second overnight PSG and SCR (T1) were performed. Results: For all subjects, both Apnea-Hypopnea Index (AHI) and total SCR score decreased significantly (<0.005) from T0 to T1. For SCR items, clinical examination (item 1) and reported sleep respiratory symptoms (item 2) ameliorated significantly (<0.005). However, hyperactivity or inattention (item 3) decreased significantly (<0.005) after treatment only in T&A group, while no differences in AHI and SCR scores occurred in the medically treated group. At T1, SCR was positive in 95.6 % of children with AHI ≥1, with a concordance of 100 % in the T&A and RME groups, resulting in a positive predictive value of 100 %. A poor concordance (38.3 % in T&A group and 53.4 % in RME group) was found when SCR < 6.5. Children with SCR ≥ 6.5 at T1 showed higher AHI compared to patients with SCR < 6.5 (5.7 ± 5.9 ev/h vs 1.78 ± 1.76 ev/h; p < 0.005). Conclusions: SCR emerges as a potentially useful instrument for follow-up of children with OSA after treatment.
AB - Purpose: The aim of our study was to evaluate the utility of the sleep clinical record (SCR) in the follow-up of children with obstructive sleep apnea (OSA) after treatment. Methods: SCR was completed and overnight polysomnography (PSG) was performed in all enrolled children (T0), with SCR considered positive for scores ≥6.5, as previously validated. Patients underwent adenotonsillectomy (T&A), rapid maxillary expansion (RME), and medical therapy according to severity of OSA and clinical features. Six months after completing therapy, the second overnight PSG and SCR (T1) were performed. Results: For all subjects, both Apnea-Hypopnea Index (AHI) and total SCR score decreased significantly (<0.005) from T0 to T1. For SCR items, clinical examination (item 1) and reported sleep respiratory symptoms (item 2) ameliorated significantly (<0.005). However, hyperactivity or inattention (item 3) decreased significantly (<0.005) after treatment only in T&A group, while no differences in AHI and SCR scores occurred in the medically treated group. At T1, SCR was positive in 95.6 % of children with AHI ≥1, with a concordance of 100 % in the T&A and RME groups, resulting in a positive predictive value of 100 %. A poor concordance (38.3 % in T&A group and 53.4 % in RME group) was found when SCR < 6.5. Children with SCR ≥ 6.5 at T1 showed higher AHI compared to patients with SCR < 6.5 (5.7 ± 5.9 ev/h vs 1.78 ± 1.76 ev/h; p < 0.005). Conclusions: SCR emerges as a potentially useful instrument for follow-up of children with OSA after treatment.
KW - Children
KW - Follow-up
KW - Obstructive sleep apnea (OSA)
KW - Residual OSA
KW - Sleep clinical record
KW - Treatment
UR - https://www.scopus.com/pages/publications/84961170663
U2 - 10.1007/s11325-015-1287-7
DO - 10.1007/s11325-015-1287-7
M3 - Article
C2 - 26564170
AN - SCOPUS:84961170663
SN - 1520-9512
VL - 20
SP - 321
EP - 329
JO - Sleep and Breathing
JF - Sleep and Breathing
IS - 1
ER -