0877 THE COMPARISON BETWEEN NAP AND OVERNIGHT POLYSOMNOGRAPHIC DATA OF PEDIATRIC OBSTRUCTIVE SLEEP APNEA.

The studies on daytime polysomnography (PSG) or Nap-PSG are very scarce. The criteria to diagnose Obstructive sleep apnea (OSA) have been changed from time to time. Furthermore, advancement in technology in this era allows more advance devices to be deployed and merged into part of PSG. These are expected to yield more accuracy when compared with the past. Snoring pediatric patients with regular nap schedule were informed and consented. Patients underwent overnight polysomnography and nap polysomnography separately, but within 2 month of each other. Both tests were done with the same recording devices and in the same manner. Patient’s sleep behavior was observed by a sleep technician and were categorized into primary snoring, mild OSA, moderate OSA and severe OSA by apnea-hypopnea index (AHI). Sleep parameters between nap-PSG and standard-PSG were compared. There were twenty nine patients (62.1% male) with median aged and IQR was 5 years old [4.5–6] and median BMI was 15.9 kg/m2[14.0–19.2], were recruited. The median AHI, arousal index of nap-PSG was 5.5 events/hour [2.0–20.9] and 21.2 events/hour [11.8–34.1], respectively, whereas those of standard-PSG were 6.9 events/hour [4.0–14.8] and 17.8 events/hour [14.8–31.1] respectively. There was no statistical significant between both groups. The best accuracy cut-point for nap-PSG to diagnosis for OSA is 2.5 events/hour, which yield sensitivity and specificity 73.1% and 100% respectively. Scatter plot showed a monotonic relationship between AHI from both tests. Spearman’s rank correlation coefficient revealed a moderate positive correlation (P-value = 0.001, correlation coefficient = 0.59). From the treatment standpoint, the AHI cut-point criterion for surgery is usually more than 5 events/hour. We found that using nap-PSG AHI cut-off point more than 20 events/hour also yielded a good positive predictive value to considered surgery, which was 100%. Nap-PSG has lower percentage of REM stage and higher percentage of N3 stage, which is similar to the early stage of normal nighttime sleep. Nap-PSG showed a promising trend as an alternative diagnostic tool for standard polysomnography. Nap-PSG cut-off more than 20 events/hour yield a good specificity for considering surgery. no