HSAT (Home Sleep Apnea Test); Evaluation of Indices and Their Relationship in Diagnosing Sleep Disordered Breathing in Children With Severe Adenoid Hypertrophy.

INTRODUCTION

Home sleep apnea test (HSAT) has been less commonly used in pediatrics compared to adults where it is widely acceptable as a diagnostic tool. It can be helpful in certain group of patients who cannot tolerate in-patient polysomnography (PSG) or at centres where PSG is not available. This study explores the relationship between different indices such as the apnoea-hypopnea index (AHI), snoring, and desaturation indices in HSAT studies in children with severe adenoid hypertrophy.

METHODS

This retrospective study evaluated HSAT data from 26 pediatric patients diagnosed with severe adenoid enlargement (based on X-ray and nasal endoscopy assessments) who were referred to pediatric sleep clinic prior to adenotonsillectomy. All studies were conducted at home using the Alice Night-One HSAT device, which includes three sensors (effort belt, cannula, and oximeter) and a built-in body position sensor, providing seven channels of data: body position, pressure flow, snoring, respiratory effort, SpO2, plethysmography, and pulse rate.

RESULTS

This study included 14 males (54%) and 12 females (46%). The average sleep time was 6.8 hours (SD ± 2.2). The study population had a median AHI of 2.8 (range: 0.3-8.2), with obstructive events predominating in 70% of the cases. Snoring episodes varied widely (0-153 events per night) and showed good positive correlation with the obstructive apnoea index (OAI) (r = 0.62, p < .05). The desaturation index (DI) ranged from 0.5 to 11.1, with severe desaturation (DI > 5) observed in 15% of patients.

CONCLUSIONS

It is helpful to conduct HSAT before planning adenotonsillectomy to decide timing and urgency of surgery. When assessed together, AHI, SI and DI can help determine the severity of sleep-disordered breathing in children with severe adenoid hypertrophy.