Scoring Methods of Polysomnography for Diagnosis of Sleep Apnea in Adolescents
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Background and Objectives Respiratory scoring guidelines for children and adults havebeen used for evaluating adolescents both in the 2007 and 2012 American Academy of SleepMedicine (AASM) scoring manuals. We compared the scoring methods of polysomnographyused in these scoring manuals, where pediatric and adult scoring rules were adopted for thediagnosis of sleep apnea in adolescents. Subjects and Method 106 Korean subjects aged between 13 and 18 years were enrolled. All subjects underwent overnight polysomnography in a sleep laboratory. Data were scored accordingto both pediatric and adult guidelines in the 2007 and 2012 AASM scoring manuals. Results Both pediatric and adult apnea hypopnea index (AHI) using the 2012 method weresignificantly higher than those using the 2007 method. The difference in AHI compared betweenpediatric and adult scores with the 2012 AASM scoring system was markedly decreasedfrom that with the 2007 method. There was a significant discordance in sleep apneadiagnosis between pediatric and adult scoring rules in the 2012 method. Conclusion Both pediatric and adult rules were used for the diagnosis of adolescent sleep apneain the 2012 method. However, there was significant discordance in the diagnosis betweenpediatric and adult scoring guidelines in the 2012 AASM manual, probably due to differentcut-off values of AHI for the diagnosis of sleep apnea in pediatric (≥1) and adult (≥5) patients. Further studies are needed to determine a more reasonable cut-off value for the diagnosis ofsleep apnea in adolescents.
Abstract
Background and Objectives Respiratory scoring guidelines for children and adults havebeen used for evaluating adolescents both in the 2007 and 2012 American Academy of SleepMedicine (AASM) scoring manuals. We compared the scoring methods of polysomnographyused in these scoring manuals, where pediatric and adult scoring rules were adopted for thediagnosis of sleep apnea in adolescents. Subjects and Method 106 Korean subjects aged between 13 and 18 years were enrolled. All subjects underwent overnight polysomnography in a sleep laboratory. Data were scored accordingto both pediatric and adult guidelines in the 2007 and 2012 AASM scoring manuals. Results Both pediatric and adult apnea hypopnea index (AHI) using the 2012 method weresignificantly higher than those using the 2007 method. The difference in AHI compared betweenpediatric and adult scores with the 2012 AASM scoring system was markedly decreasedfrom that with the 2007 method. There was a significant discordance in sleep apneadiagnosis between pediatric and adult scoring rules in the 2012 method. Conclusion Both pediatric and adult rules were used for the diagnosis of adolescent sleep apneain the 2012 method. However, there was significant discordance in the diagnosis betweenpediatric and adult scoring guidelines in the 2012 AASM manual, probably due to differentcut-off values of AHI for the diagnosis of sleep apnea in pediatric (≥1) and adult (≥5) patients. Further studies are needed to determine a more reasonable cut-off value for the diagnosis ofsleep apnea in adolescents.
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