Prioritising Polysomnography in Children with Suspected Obstructive Sleep Apnoea: Key Roles of Symptom Onset and Sleep Questionnaire Scores.

IF 2 4区 医学 Q2 PEDIATRICS Children-Basel Pub Date : 2024-10-10 DOI:10.3390/children11101228
Luana Nosetti, Marco Zaffanello, Daniela Simoncini, Gaia Dellea, Maddalena Vitali, Hajar Amoudi, Massimo Agosti
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Abstract

Background/objectives: Obstructive Sleep Apnoea Syndrome (OSA) in children disrupts normal breathing patterns and sleep architecture, potentially leading to severe consequences. Early identification and intervention are crucial to prevent these issues. This study explored the relationships between waiting times for polysomnography (PSG), clinical history, patient age at the time of PSG, and PSG outcomes in children.

Methods: Two hundred and fourteen children were prospectively enrolled. Data were extracted from medical records regarding the patients' age at the time of a referral for PSG and their age at the time of its execution. Information on the waiting times for PSG, a diagnosis (primary snoring, mild, moderate, and severe OSA), and a history of snoring and apnoea were also collected. Additional data included medications, surgical interventions, passive smoke exposure, and allergies. The records also included the Paediatric Sleep Questionnaire (PSQ).

Results: The patient age at the time of a PSG prescription was lower for patients with a short history of sleep apnoeas (≤12 months; 4.6 (SD 2.6) years) compared to those with a long history (>12 months; 5.5 (SD 2.7) years; p = 0.027). The waiting time from prescription to PSG execution was shorter for patients with a short history of sleep apnoea (4.1 (SD 3.8) months) compared to those with a longer history (5.9 (SD 3.8) months; p = 0.001). A higher frequency of having an adenotonsillectomies before a PSG prescription was observed in the long-history group compared to the short-history group (13.3% vs. 6.9%). Conversely, a higher frequency of adenoidectomies before a PSG prescription was noted in the short-history group compared to the long-history group (9.7% vs. 1.3%).

Conclusions: This study found that younger children with a shorter history of OSA are diagnosed and evaluated earlier than older children with a longer history of the condition, suggesting that prolonged symptoms may delay a diagnosis. ENT surgeries also vary among patients, with less invasive procedures (adenoidectomy) being more common in younger children with shorter histories of OSA. The increasing awareness of OSA highlights the need for improved access to diagnostic and treatment resources.

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对疑似阻塞性睡眠呼吸暂停的儿童优先进行多导睡眠图检查:症状发作和睡眠问卷评分的关键作用。
背景/目的:儿童阻塞性睡眠呼吸暂停综合症(OSA)会扰乱正常的呼吸模式和睡眠结构,可能导致严重后果。早期识别和干预对预防这些问题至关重要。本研究探讨了儿童接受多导睡眠图检查(PSG)的等待时间、临床病史、接受 PSG 检查时的患者年龄与 PSG 检查结果之间的关系:方法: 该研究对 214 名儿童进行了前瞻性登记。从医疗记录中提取了有关患者转诊接受 PSG 时的年龄和实施 PSG 时的年龄的数据。此外,还收集了有关 PSG 等待时间、诊断(原发性打鼾、轻度、中度和重度 OSA)以及打鼾和呼吸暂停病史的信息。其他数据包括药物、手术干预、被动吸烟和过敏。记录还包括儿童睡眠问卷(PSQ):结果:开 PSG 处方时,睡眠呼吸暂停病史短(≤12 个月;4.6 (SD 2.6) 岁)的患者年龄低于病史长(>12 个月;5.5 (SD 2.7) 岁;p = 0.027)的患者。与病史较长的患者(5.9 (SD 3.8) months; p = 0.001)相比,睡眠呼吸暂停病史较短的患者从开具处方到执行 PSG 的等待时间较短(4.1 (SD 3.8) months)。与短病史组相比,长病史组在 PSG 处方前进行腺样体切除术的频率更高(13.3% 对 6.9%)。相反,与长病史组相比,短病史组在 PSG 处方前进行腺样体切除术的频率更高(9.7% 对 1.3%):本研究发现,OSA病史较短的年幼儿童比病史较长的年长儿童更早得到诊断和评估,这表明症状持续时间较长可能会延误诊断。患者接受耳鼻喉科手术的情况也不尽相同,创伤较小的手术(腺样体切除术)在OSA病史较短的年幼儿童中更为常见。人们对 OSA 的认识不断提高,这凸显了改善诊断和治疗资源的必要性。
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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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