Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1217 - 1221 |
| Number of pages | 5 |
| Journal | Journal of Clinical Sleep Medicine |
| Volume | 10 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2014 |
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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 journal › Article › Research › peer-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 -