Introduction and Objective: Current guidelines recommend polysomnography(PSG) for all children with Down Syndrome(DS) for screening obstructive sleep apne syndrome(OSAS). The aim of our study was to evaluate the diagnostic reliability and feasibility of home respiratory polygraphy(HRP) in DS.
Methods: National DS Association was contacted and children aged 6-18 years who accepted to participate were recruited. Sleep history was taken, questionnaires (pediatric sleep questionnaire, OSA-18, Pittsburgh sleep quality index(PSQI)), otorhinolaryngologic evaluation, in-lab PSG were performed. Families were given instructions and an unattended HRP was done within a week with a portable type3 device. OSAS was defined as an Apnea-Hypopnea Index (AHI)≥2 and/or obstructive AHI≥1episodes/h. OSAS severity was classified mild if AHI is ≥2 and <5, moderate if AHI is ≥5 and <15 and severe if AHI≥15. AHI, OAHI, oxygen desaturation index (ODI) were compared.
Results: 19 children (12 girls, %63) were recruited. Mean age was 12.0±3.1 yrs. Snoring was reported in 12(63%) pts. Children diagnosed with OSAS had significantly higher OSA18 and PSQI positivity (p=0.046). HRP was uninterpretable in two patients (11%) and had to be repeated. PSG revealed OSAS in 6(32%) patients, 2 had mild and 4(21%) had severe OSAS. HRP revealed OSAS in 16 pts (84%). Four (21%) had severe and 12(63%) had mild OSAS. PSG and HRP results correlated in diagnosing severe OSAS. Positive predictive value of HRP was 38% and negative predictive value was 100(%).
Conclusion: HRP is accurate in diagnosing severe apnea in children with Down syndrome.When AHI≥2 and/or OAHI≥1 is taken as OSAS criteria, false positive results may be detected.