Video-respiratory polygraphy for the diagnosis of obstructive sleep apnea in children

Polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea syndrome in children. The presence of numerous electrodes poses an impediment and limits children's acceptance. Respiratory polygraphy (RP) has less electrodes and is more tolerable for children and the use of video-camera (vRP) may provide a more precise estimation of the total sleep time (TST) compared to RP alone. The aim of this study was to compare the respiratory parameters obtained by vRP reported to PSG and RP. 66 children/PSG’s were included in this study, with median [1st; 3rd quartile] age of 9 [7; 12]y. Few weeks after the initial PSG analysis, the analysis was deleted, and the recording analyzed by taking into account only the respiratory signals (RP) and after other few weeks, only the respiratory signals and the video-recording (vRP). Obstructive apnea-hypopnea index (OAHI) in vRP, 6.1 [3.5; 11.7]/h, was underestimated reported to PSG, 8.6 [5.7; 13.4]/h in PSG, (<italic>p<</italic>0.0001) but larger vs RP, 5.5 [3.1; 10.3]/h, (<italic>P=</italic>0.0002). 19 (29%) children changed the severity status in vRP, 1 from mild in PSG to normal in vRP, 10 from moderate to mild, 5 from severe to moderate and 3 from severe to mild. Video-PG serves as substitute for PSG, being a more convenient exam, readily accepted by children, less underestimating OAHI reported to RP alone. The inclusion of the video-camera improves the precision of the TST estimation. Nevertheless, the respiratory events linked to microarousals are disregarded, which results in the underestimate of OAHI.