Childhood Obstructive Sleep Apnea Syndrome: Clinical and Polysomnographic Findings

Park, Yang Jun; Koh, Dae Kyun; Oh, Jin Hee; Lee, Soo Jung

Abstract

PURPOSE
Although pediatricians may see a lot of patients with clinically suspected obstructive sleep apnea syndrome(OSAS), the actual incidence, clinical and polysomnographic manifestations of OSAS in children have not well been recognized and reported cases are rare. The objective of this study was to evaluate the efficacy of polysomnography in the diagnosis of OSAS in children and to analyze the polysomnographic findings and its correlations with clinical histories and predisposing factors.
METHODS
Clinical histories, physical examination, radiograph of the upper airway and overnight polysomnograph were conducted in 57 children with clinically suspected OSAS from August 1997 to August 1998.
RESULTS
Forty three(73%) of the 57 children met the polysomnographic criteria of pediatric OSAS, twenty three(53%) among whom had severe OSAS. Male : female ratio of children with OSAS was 1.5 : 1. The peak age at the time of diagnosis was 4 to 6 years. The most common predisposing factor was adenotonsillar hypertrophy. Snoring was the most common clinical manifestation in all cases and followed by apnea, mouth breathing, restless sleep, and labored breathing. An overnight polysomnography was a valuable tool for the diagnosis and assessment of the severity of OSAS. Adenoidectomy and/or tonsillectomy was the most effective therapeutic option. Recovery of symptoms was observed following surgery.
CONCLUSION
This study will be useful for pediatricians to diagnose and to decide the therapeutic modalities of the OSAS, with an understanding of the clinical manifestations of OSAS and a recognition of the necessity of polysomnography.