[Diagnosis of pediatric obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To discuss the clinical feature and diagnosis of pediatric obstructive sleep apnea hypopnea syndrome (OSAHS) and analyze characteristics of polysomnography. METHODS: Cephalometric analysis, fibrous endoscopic examination and sleep breathing studies were performed in 49 cases with suspected complaints and signs. RESULTS: Most of them had marked history about snore, sleep apnea and signs of upper airway obstruction caused by enlargement of tonsil and/or adenoid. Polysomnography (PSG) was given to 41 cases who was proved 1 case with primary snore, 5 cases with upper airway resistance syndrome, 35 cases with OSAHS. Another 8 cases with OSAHS were diagnosed by Autoset I studies. CONCLUSION: Many features of pediatric OSAHS are different from adult OSAHS. The common symptom of pediatric OSAHS include snore, restless sleep, struggling to breathe, abnormal paradoxical chest/abdomen motion, mouth breathing, failure-to-thrive. Obesity and excessive daytime sleepiness are little present. Severe cases may be associated with cor pulmonale. PSG play an important role in exact diagnosis of pediatric sleep related breathing disorder. The results demonstrate that pediatric OSAHS are characterized by partial upper airway obstruction, more or less apnea and associated with staged desaturation. They have little sleep structure disorder and difficulty breathing are not associated with arousal. Apnea hypopnea index (AHI), lowest oxygen saturation (LSaO2) and desaturation index below 90% (SIT90%) are very important factors to measure about serious degree of pediatric OSAHS.