The impact of recent changes to the respiratory scoring rules in pediatrics

Research output: Contribution to journalArticleResearchpeer-review

Abstract

In 2007 the American Academy of Sleep Medicine (AASM) published polysomnography (PSG) scoring guidelines, which were updated in 2012. A key change in terms of scoring respiratory events in children was the threshold for reduction in airflow (50 vs 30 ) for the definition of hypopnea. This study aimed to determine the impact of different scoring rules on the assessment of severity of obstructive sleep apnea (OSA) in children. METHODS: Forty-two children (mean age 4.3 y, 16 F) underwent PSG. An obstructive apnea-hypopnea index (OAHI) was determined using three scoring rules: (1) ATS 1996 rules with minor modifications (modified ATS 1996); (2) AASM 2007 rules (AASM 2007); and (3) AASM 2007 rules with respiratory event related arousals included in the OAHI (AASM+RERA). RESULTS: The AASM 2007 OAHI (median 0.4 events/h, range 0, 14) was lower than the modified ATS 1996 OAHI (median 0.8 range 0, 26.1, p <0.001), underestimating severity of disease in 24 of cases. The AASM+RERA OAHI (median 0.8, range 0, 19.1) was also lower than the modified ATS 1996 OAHI (p = 0.02), but the difference was not clinically significant except at very high OAHIs. CONCLUSION: The AASM 2007 rules lead to a lower OAHI and lesser OSA severity when compared to the previous standard. Inclusion of RERAs in the AASM 2007 OAHI leads to a comparable OAHI to the previous rules. Given that morbidity has been demonstrated even in mild OSA, these results support the inclusion of events with a reduction in airflow of less than 50 as included in the updated AASM rules in 2012.
Original languageEnglish
Pages (from-to)1217 - 1221
Number of pages5
JournalJournal of Clinical Sleep Medicine
Volume10
Issue number11
DOIs
Publication statusPublished - 2014

Cite this

@article{3e987b901bed49b8bbe8c37eb19f2e2d,
title = "The impact of recent changes to the respiratory scoring rules in pediatrics",
abstract = "In 2007 the American Academy of Sleep Medicine (AASM) published polysomnography (PSG) scoring guidelines, which were updated in 2012. A key change in terms of scoring respiratory events in children was the threshold for reduction in airflow (50 vs 30 ) for the definition of hypopnea. This study aimed to determine the impact of different scoring rules on the assessment of severity of obstructive sleep apnea (OSA) in children. METHODS: Forty-two children (mean age 4.3 y, 16 F) underwent PSG. An obstructive apnea-hypopnea index (OAHI) was determined using three scoring rules: (1) ATS 1996 rules with minor modifications (modified ATS 1996); (2) AASM 2007 rules (AASM 2007); and (3) AASM 2007 rules with respiratory event related arousals included in the OAHI (AASM+RERA). RESULTS: The AASM 2007 OAHI (median 0.4 events/h, range 0, 14) was lower than the modified ATS 1996 OAHI (median 0.8 range 0, 26.1, p <0.001), underestimating severity of disease in 24 of cases. The AASM+RERA OAHI (median 0.8, range 0, 19.1) was also lower than the modified ATS 1996 OAHI (p = 0.02), but the difference was not clinically significant except at very high OAHIs. CONCLUSION: The AASM 2007 rules lead to a lower OAHI and lesser OSA severity when compared to the previous standard. Inclusion of RERAs in the AASM 2007 OAHI leads to a comparable OAHI to the previous rules. Given that morbidity has been demonstrated even in mild OSA, these results support the inclusion of events with a reduction in airflow of less than 50 as included in the updated AASM rules in 2012.",
author = "Nixon, {Gillian Michelle} and Meliisa Hyde and Biggs, {Sarah Nichole} and Walter, {Lisa Mary} and Horne, {Rosemary Sylvia Claire} and Davey, {Margot J}",
year = "2014",
doi = "10.5664/jcsm.4206",
language = "English",
volume = "10",
pages = "1217 -- 1221",
journal = "Journal of Clinical Sleep Medicine",
issn = "1550-9389",
publisher = "American Academy of Sleep Medicine",
number = "11",

}

The impact of recent changes to the respiratory scoring rules in pediatrics. / Nixon, Gillian Michelle; Hyde, Meliisa; Biggs, Sarah Nichole; Walter, Lisa Mary; Horne, Rosemary Sylvia Claire; Davey, Margot J.

In: Journal of Clinical Sleep Medicine, Vol. 10, No. 11, 2014, p. 1217 - 1221.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The impact of recent changes to the respiratory scoring rules in pediatrics

AU - Nixon, Gillian Michelle

AU - Hyde, Meliisa

AU - Biggs, Sarah Nichole

AU - Walter, Lisa Mary

AU - Horne, Rosemary Sylvia Claire

AU - Davey, Margot J

PY - 2014

Y1 - 2014

N2 - In 2007 the American Academy of Sleep Medicine (AASM) published polysomnography (PSG) scoring guidelines, which were updated in 2012. A key change in terms of scoring respiratory events in children was the threshold for reduction in airflow (50 vs 30 ) for the definition of hypopnea. This study aimed to determine the impact of different scoring rules on the assessment of severity of obstructive sleep apnea (OSA) in children. METHODS: Forty-two children (mean age 4.3 y, 16 F) underwent PSG. An obstructive apnea-hypopnea index (OAHI) was determined using three scoring rules: (1) ATS 1996 rules with minor modifications (modified ATS 1996); (2) AASM 2007 rules (AASM 2007); and (3) AASM 2007 rules with respiratory event related arousals included in the OAHI (AASM+RERA). RESULTS: The AASM 2007 OAHI (median 0.4 events/h, range 0, 14) was lower than the modified ATS 1996 OAHI (median 0.8 range 0, 26.1, p <0.001), underestimating severity of disease in 24 of cases. The AASM+RERA OAHI (median 0.8, range 0, 19.1) was also lower than the modified ATS 1996 OAHI (p = 0.02), but the difference was not clinically significant except at very high OAHIs. CONCLUSION: The AASM 2007 rules lead to a lower OAHI and lesser OSA severity when compared to the previous standard. Inclusion of RERAs in the AASM 2007 OAHI leads to a comparable OAHI to the previous rules. Given that morbidity has been demonstrated even in mild OSA, these results support the inclusion of events with a reduction in airflow of less than 50 as included in the updated AASM rules in 2012.

AB - In 2007 the American Academy of Sleep Medicine (AASM) published polysomnography (PSG) scoring guidelines, which were updated in 2012. A key change in terms of scoring respiratory events in children was the threshold for reduction in airflow (50 vs 30 ) for the definition of hypopnea. This study aimed to determine the impact of different scoring rules on the assessment of severity of obstructive sleep apnea (OSA) in children. METHODS: Forty-two children (mean age 4.3 y, 16 F) underwent PSG. An obstructive apnea-hypopnea index (OAHI) was determined using three scoring rules: (1) ATS 1996 rules with minor modifications (modified ATS 1996); (2) AASM 2007 rules (AASM 2007); and (3) AASM 2007 rules with respiratory event related arousals included in the OAHI (AASM+RERA). RESULTS: The AASM 2007 OAHI (median 0.4 events/h, range 0, 14) was lower than the modified ATS 1996 OAHI (median 0.8 range 0, 26.1, p <0.001), underestimating severity of disease in 24 of cases. The AASM+RERA OAHI (median 0.8, range 0, 19.1) was also lower than the modified ATS 1996 OAHI (p = 0.02), but the difference was not clinically significant except at very high OAHIs. CONCLUSION: The AASM 2007 rules lead to a lower OAHI and lesser OSA severity when compared to the previous standard. Inclusion of RERAs in the AASM 2007 OAHI leads to a comparable OAHI to the previous rules. Given that morbidity has been demonstrated even in mild OSA, these results support the inclusion of events with a reduction in airflow of less than 50 as included in the updated AASM rules in 2012.

UR - http://www.ncbi.nlm.nih.gov/pubmed/25325599

U2 - 10.5664/jcsm.4206

DO - 10.5664/jcsm.4206

M3 - Article

VL - 10

SP - 1217

EP - 1221

JO - Journal of Clinical Sleep Medicine

JF - Journal of Clinical Sleep Medicine

SN - 1550-9389

IS - 11

ER -