Role of the ENT specialist in the diagnosis of pediatric obstructive sleep apnea-hypopnea syndrome (POSAHS). Part 3: sleep recordings

Akkari, M.; Yıldız, Şule; Marianowski, R.; Monteyrol, Pierre-Jean; Chalumeau, F.; Fayoux, P.; Leboulanger, N.; Franco, Patricia; Couloigner, V.; Mondain, M.

doi:10.1016/j.anorl.2020.02.001

Cited by 4 publications

(16 citation statements)

References 38 publications

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“…En niños con SAOS, se registran picos de desaturación (≥ 3 picos de ≥ 4%) y / o ≥ 3 episodios de desaturación <90% y / o un índice de desaturación de oxígeno (IDO) > 2.2 episodios por hora. Después de los 13 años de edad, se utilizan los criterios de interpretación de los adultos, establecidos por la AASM (35).…”

Section: Diagnóstico Del Saos Y Tipos De Estudios Del Sueñounclassified

“…Dentro de las ventajas de la PR con respecto a la PSG (sobretodo de los estudios de Tipo I) encontramos: un coste menor, no implica la supervisión por parte del personal médico y puede llevarse a cabo en un centro hospitalario que no sea especializado en el estudio del sueño o en casa, lo cual en este último caso permite una mejor calidad del sueño gracias a un ambiente familiar y un acceso más fácil; presenta un número menor de sensores, lo que significa una configuración más rápida del dispositivo y una mejor aceptación por parte del paciente; la interpretación es más rápida, normalmente de 20-30 minutos, en comparación PSG que requiere al menos 2 horas (28,35). Por otro lado, las desventajas de la PR son: la subestimación antes descrita del IAH, los ERAM no pueden ser puntuados, porque los despertares no pueden ser identificados, la ausencia de supervisión y una configuración no controlada del dispositivo pueden inducir a artefactos o tiempo de grabación insuficiente, la calidad de la señal puede verse afectada por los sensores que se sueltan, especialmente en los niños, como la cánula nasal y el sensor de oximetría de pulso (32,35).…”

Section: Diagnóstico Del Saos Y Tipos De Estudios Del Sueñounclassified

“…Sin embargo, son fáciles de usar, económicos, se pueden realizar en casa, lo que permite un entorno más familiar y cómodo, los tiempos de espera son más cortos y son más alcanzables que la PSG; por lo tanto, podrían respaldar pruebas más amplias para el SAOS en la población general sin comorbilidades, como un medio de expandir el diagnóstico de enfermedad subclínica y abordar la carga de salud de la población del SAOS. Además, pueden usarse como un método de detección para pacientes con alta sospecha clínica de SAOS que luego se remitirían para la prueba definitiva con la PSG (35,42,43).…”

Section: Diagnóstico Del Saos Y Tipos De Estudios Del Sueñounclassified

“…En los estudios del sueño de Tipo IV se encuentran: la oximetría nocturna, la pulsofotoplestismografía, el tiempo de tránsito de pulso, el sensor supraesternal, la detección de los movimientos verticales de la mandíbula y la medición del monóxido de nitrógeno (35).…”

Section: Diagnóstico Del Saos Y Tipos De Estudios Del Sueñounclassified

“…Este examen puede ser realizado en casa o en un ambiente hospitalario no especializado. La interpretación tiene en cuenta la saturación media de oxígeno, el número de episodios de desaturación ≥ 3% y el tiempo de porcentaje con SaO2 <90% (35).…”

Section: Diagnóstico Del Saos Y Tipos De Estudios Del Sueñounclassified

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Análisis de los métodos más eficaces para el cribado del síndrome de apnea obstructiva del sueño en la clínica dental

Rossi¹

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Introduction: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder, that determines severe sequelae on affected people's health. The gold standard to diagnose OSA is the polysomnography, which however is expensive, time-consuming, laborintensive and not always available. Therefore, OSA is underdiagnosed, and thus, given the severity of its consequences, it represents a significant burden for the health system.To solve this problem easy-to-perform screening methods are needed to identify subjects at high risk of OSA. Dentists are particularly well placed to carry out this initial tests.Objective: To review the available bibliographic data to identify the best screening methods to detect potential OSA patients during dental clinical practice, both for adults and children. Methods:Relevant studies published up to April 2021 were sourced from PubMed, Embase, MEDLINE, Cochrane, and LILACS databases.Results: 93 studies were selected, 52 for adults and 41 for children. The screening methods available to the dentist included questionnaires, pulse oximetry, analyses of the upper airways and anatomical factors. Some of these were found to be adequate tools for certain specific purposes, but none of them presented all the characteristics required to be considered a good screening method for OSA on a standalone basis. It is thus necessary to combine multiple of them to achieve a sufficient precision in OSA detection. This is supported by some of the reviewed studies, but it should be further researched.Dentists have a fundamental role in early detection of potential OSA cases since they can use the methods described in this review to perform an initial screening of the population and address the identified subjects to sleep physicians. Sleep Apnea Clinical Score Flemons WW y cols. (62) 1994 4 + tabla de putuación Cuestionario es el de Berlín (CB) Conferencia sobre el sueño en atención primaria celebrada en Berlín. (63) 1996 11 Escala NOSE Stewart MG y cols. (66) 2004 ASA checklist Grupo de trabajo de la Sociedad Americana de Anestesiólogos. (68) 2006 12 Apnea Risk Evaluation System (ARES) Levendowski DJ y cols. (69) 2007 5 + EES STOP Chung F y cols. (70) 2008 STOP-Bang Chung F y cols. (70) 2008 Four-Variable Screening Tool (4-VST) Takegami M y cols. (71) 2009 Ecuación de 4 variables.

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Section: Diagnóstico Del Saos Y Tipos De Estudios Del Sueñounclassified

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Análisis de los métodos más eficaces para el cribado del síndrome de apnea obstructiva del sueño en la clínica dental

Rossi¹

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Drug‐Induced sleep endoscopy in children: NAVOTEL scoring system development

Qarbal

Treut-Gay

Allali

et al. 2023

Pediatric Pulmonology

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Objectives: Pediatric drug-induced sleep endoscopy (DISE) lacks a universal and easy-to-use scoring system. The velum, oropharynx, tongue, epiglottis (VOTE) scoring system is widely used but needs to be completed in pediatrics. The main objective of this study was to investigate the distribution of obstructive sites in DISE and to propose an appropriate pediatric scoring system. The secondary objective was to evaluate the changes in surgical management induced by the proposed scoring system.Methods: A single-center prospective 5-year study was conducted from March 2016 to December 2021, including 99 children with a mean age of 7.2 years (±3.7), with pathological preoperative sleep recordings and undergoing DISE. The distribution of all upper airway obstructive sites was studied.Results: Adenoids (A) were the most frequent obstructive site (63% of patients), and the nasal cavities (N) and the larynx (L) were other frequent obstructive sites. These sites are not explored by the VOTE scoring system, leading to the creation of the nose, adenoids, velum, oropharynx, tongue, epiglottis, larynx (NAVOTEL) scoring system. NAVOTEL was significantly correlated with the severity of obstructive sleep apnea-hypopnea syndrome (OSAS) (ρ = 0.2; p = 0.04) and highlighted obstructive sites in 6/9 patients with VOTE = 0. Of these patients, 4 had a complete obstructive site, and 3 had a multisite obstruction. VOTE indicated 8 additional surgical actions; NAVOTEL indicated 50 other actions compared to clinical examination. The NAVOTEL scoring system was exhaustive regarding surgical indications for OSAS.Conclusions: The NAVOTEL scoring system is exhaustive in pediatric DISE and correlated to OSAS severity. It should be preferred in pediatric DISE.

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Plasma tRF-16-79MP9PD and tRF-28-OB1690PQR304 as potential biomarkers for 4- to 7-year-old children with obstructive sleep apnea-hypopnea syndrome

Cai

et al. 2023

Front. Pediatr.

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BackgroundWe investigated the expression and the potential value of plasma transfer RNA-derived fragments (tRFs) of children with obstructive sleep apnea–hypopnea syndrome (OSAHS) as screening biomarkers.MethodsAt first, we randomly selected five plasma samples from the case group and the control group for high-throughput RNA sequencing. Secondly, we screened two tRFs with different expression between the two groups, amplified it by quantitative reverse transcription-PCR (qRT-PCR) on all samples. Then we analyzed the diagnostic value of the tRFs and their correlation with the clinical data.ResultsA total of 50 OSAHS children and 38 healthy controls were included. Our results demonstrated that the plasma levels of tRF-16-79MP9PD and tRF-28-OB1690PQR304 were significantly down-regulated in OSAHS children. Receiver operating characteristic curve (ROC) showed that the area under the curve (AUC) of tRF-16-79MP9PD and tRF-28-OB1690PQR304 was 0.7945 and 0.8276. In addition, the AUC of the combination reached 0.8303 with 73.46% and 76.42% sensitivity and specificity. Correlation analysis showed that the degree of tonsil enlargement, hemoglobin (Hb) and triglyceride (TG). were related to the expression levels of tRF-16-79MP9PD and tRF-28-OB1690PQR304. Multivariable linear regression analysis showed that degree of tonsil enlargement, Hb and TG related to tRF-16-79MP9PD while degree of tonsil enlargement and Hb related to tRF-28-OB1690PQR304.ConclusionsThe expression levels of tRF-16-79MP9PD and tRF-28-OB1690PQR304 in the plasma of OSAHS children decreased significantly which were closely related to the degree of tonsil enlargement, Hb and TG, may become novel biomarkers for the diagnosis of pediatric OSAHS.

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Role of the ENT specialist in the diagnosis of pediatric obstructive sleep apnea-hypopnea syndrome (POSAHS). Part 3: sleep recordings

Cited by 4 publications

References 38 publications

Análisis de los métodos más eficaces para el cribado del síndrome de apnea obstructiva del sueño en la clínica dental

Análisis de los métodos más eficaces para el cribado del síndrome de apnea obstructiva del sueño en la clínica dental

Drug‐Induced sleep endoscopy in children: NAVOTEL scoring system development

Plasma tRF-16-79MP9PD and tRF-28-OB1690PQR304 as potential biomarkers for 4- to 7-year-old children with obstructive sleep apnea-hypopnea syndrome

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