Sleep clinical record and polysomnography scores in adolescents with sleep disordered breathing

Introduction: According to the update of the American Academy of Sleep Medicine (AASM) manual either paediatric or adult scoring rules may be used for adolescents ages 13 -18 years but there are no definitive recommendations on which respiratory scoring rules are most appropriate. Objectives: compare polysomnographic parameters in a group of adolescents with suspected sleep disordered breathing (SDB), using both pediatric and adult respiratory scoring criteria and to identify the main clinical factors associated with obstructive sleep apnoea severity by sleep clinical record (SCR). Methods: A prospective study was conducted on adolescents referred for SDB between 2015-2017. Every patients performed clinical evaluation, SCR and overnight polysomnography. Data were scored using both adult and pediatric AASM criteria. Results: Seventy-one adolescents were studied (mean age 14.2± 1.6 years, 68.3 % were male, 25.4% were obese). SCR was positive in 29 (40.8%) patients. The difference between AHI scored by pediatric (median 1.0[0.6–2.1]/h) and adult (median 0.1[0.4 – 0.9]/h) criteria was statistically significant (p=0.000). There was a significant rate of discordance for OSAS classification, 26 pediatric OSAS vs 6 adult OSAS (p=0.01). All patients with OSAS had a positive SCR and main clinical findings OSA-related were dento-skeletal malocclusion (OR 9.6, 95% CI 2.3-39.8, p=0.001), nasal septal deviation (OR 4.6, 95% CI 1.1-18.6, p=0.02) and obesity (OR4.0, 95% CI 1.1-14.4, p=0.02). Conclusions: we suggest to use the pediatric scoring rules in adolescents with SDB, in order to identify a correct number of patients with OSAS.