THE DIAGNOSTIC VALUE OF THE SYMPTOMS IN THE DIFFERENTIATION OF HABITUAL SNORING and THE PEDIATRIC OBSTRUCTIVE SLEEP APNEA SYNDROME
1Zonguldak Karaelmas Üniversitesi, KBB Anabilim Dalı, Zonguldak, Türkiye2Zonguldak Karaelmas Üniversitesi, Pediatri Anabilim Dalı, Zonguldak, Türkiye
3Zonguldak Karaelmas Üniversitesi, Göğüs Hastalıkları Anabilim Dalı, Zonguldak, Türkiye Objective:
Obstructive sleep apnea syndrome (OSAS) in children is a serious disease , estimated to occur in approximately 2% of children and is characterized by repeated episodes of complete or partial upper airway obstruction during sleep. Habitual snoring (HS) is a common symptom seen in %7-9 of children. Although theres no hypercapnia and hypercapnia in HS, presence of snoring and other symptoms suggestive of OSAS in HS makes the clinical differentiation of these two clinical conditions a challenging one. In this study we evaluated children with HS and OSAS and assessed the diagnostic value of symptoms in the clinical differentiation of these two disorders.
Method:
74 children with every night snoring symptom were included in this study. Detailed history with regard to OSAS symptoms is taken and physical examination is performed in each child. Children were classified in either OSAS or HS group according polysomnography results. Children with more than two spells of apnea or hypopnea per hour of sleep were classified as OSAS. The frequency of presence of symptoms in the HS and OSAS groups were compared with chi square test. When the frequency of any symptom was found statistically different between two groups, the sensitivity and specificity values were calculated. The correlation between each symptom and AHI analyzed by Pearson Correlation test.
Results:
The frequency of the presence of open mouth breathing, restlessness in sleep and open mouth sleeping symptoms were found to be significantly different between the two groups (x2<0.05). The specificity value for the presence of open mouth breathing, restlessness in sleep and open mouth sleeping symptoms together in a child was found to be 89.5%.
Conclusion:
We suggest that patients with the triad of open mouth breathing, restlessness in sleep and open mouth sleeping that is accompanied with adenoid and or tonsillary hypertrophy must be accepted to be at a higher risk for OSAS and in centers where polysomnography is not available priority should be given to their treatment with adenotonsillectomy.