Interpretation of sleep studies and perioperative considerations in children with sleep-disordered breathing

Question 1

Subtypes of sleep-disordered breathing in children

Answer 1

• OSA
• Central sleep-disordered breathing

Question 2

Causes of sleep-disordered breathing in children

Answer 2

• Hypertrophy of adenoids and tonsils
• Craniofacial abnormalities (Apert syndrome, Crouzon)
• Obesity
• Genetic syndromes (Robin’s syndrome, Trisomy 21)
• Neuromuscular conditions

Question 3

Symptoms of sleep-disordered breathing in children

Answer 3

• Snoring
• Laboured breathing
• Neck hyperextension
• Difficulty concentrating
• Learning difficulties
• Nocturnal enuresis

Question 4

Signs of sleep-disordered breathing in children

Answer 4

• Tonsillar hypertrophy
• Mandibular hypoplasia
• LV hypertrophy
• Pulmonary HTN

Question 5

What information does polysomnography gather

Answer 5

• Respiratory: nasal airflow, thorax and abdominal wall movements, ETCO2
• Cardiac: ECG and SpO2
• Neurology channel: EEG, chin and leg EMG
• Body position
• Snore microphone
• Video

Question 6

Apnoea- Hypnoea Index in children cut-offs for severity of OSA

Answer 6

<1 normal
1-5 mild
5-10 moderate
>10 severe

Question 7

Types of sleep study

Answer 7

• Polysomnography- gold standard
• Cardiorespiratory sleep study- polysomnography without EEG and EMG
• Overnight pulse oximetry