Full polysomnographic evaluation of the infant airway.

BACKGROUND

There is little information regarding full polysomnographic examination of infants for the evaluation of stridor or stertor.

OBJECTIVE

To determine the usefulness of polysomnographic examination in the evaluation of airway disorders in infants.

DESIGN

Case review series.

SETTING

Tertiary pediatric care center and sleep disorders center.

PATIENTS: Younger than 10 months.

INTERVENTION: Full polysomnography and treatment with a positive-pressure assistive device or surgery if indicated.

MAIN OUTCOME MEASURES: Electroencephalographic findings, amount and length of apnea, percentage of desaturation and carbon dioxide retention, sleep architecture, amount of hypopnea as well as sleep arousals, episodes of gastroesophageal reflux, and clinical follow-up.

RESULTS

Of 60 full pediatric polysomnograms performed at our institution each year, only 17 were obtained in children younger than 10 months for determination of symptoms of stridor or stertor over the past 8 years. In several cases, interpretation of 4-channel studies led to the wrong conclusions and inadequate treatment. Diagnoses made using full polysomnography included 3 children with seizure disorders, 1 with disorganized brain activity, 2 with gastroesophageal reflux, and 7 with anatomical obstructions, 3 of whom were successfully treated with a positive-pressure assistive device and 4 of whom were treated surgically.

CONCLUSIONS

Full polysomnography provides physiological data that complement anatomical data obtained via endoscopy and is a useful tool for evaluating the significance of airway disorders in infants.