MedPath

Clinical Predictors of Pediatric OSAHS

Conditions
Pediatric Sleep Apnea
Registration Number
NCT02627937
Lead Sponsor
Chang Gung Memorial Hospital
Brief Summary

The purpose of this study is to develop adequate and satisfactory tools using reliable clinical and physical factors in predicting pediatric obstructive sleep apnea/hypopnea syndrome (OSAHS) and allow greater access to appropriate therapy in children.

Detailed Description

The prevalence of OSAHS is estimated to be about 1% to 4% in children, however, it is frequently underdiagnosed because of the difficulties for evaluation.Current diagnostic approaches are based on the patient's history, clinical presentation and physical examination, endoscopy, and radiological imaging examinations, and confirmation is made by the current gold standard of full-night polysomnography (PSG). Previous studies have reported the use of a clinical history, physical examination and questionnaires for predicting pediatric OSAHS but there were lacking of adequate and satisfactory results. Despite the potential diagnostic benefits, PSG for pediatric patients are not routinely used in clinical practice. Therefore, to obtain a reliable, valid, and easily-performed diagnostic or screening tool for the clinical assessment of pediatric OSAHS is essential for the cost-effective care of these patients.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
88
Inclusion Criteria
  • children (younger than 18 years old and older than 2 years old) with symptoms of snoring and then were confirmed to having obstructive sleep apnea/hypopnea syndrome by a comprehensive polysomnography
Exclusion Criteria
  • patients with substance abuse problems or the long-term usage of medications known to affect sleep, craniofacial abnormalities or neuromuscular disorders, Down syndrome, cerebral palsy, mucopolysaccharidoses, Prader-Willi syndrome, history of psychosis, central sleep apnea syndrome, or previous airway surgery including tonsillectomy and/or adenoidectomy were excluded from the study.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Clinical predictors for apnea/hypopnea index (AHI)up to 4 months

When all variables were analyzed individually with the AHI, Spearman rank correlation analysis was used to explore the relationships between clinical predictor variables and AHI.Significant variables were entered into stepwise multiple linear regression analysis to identify independent predictors for pediatric OSAHS and to develop a predictive equation for AHI values.

Secondary Outcome Measures
NameTimeMethod
Anthropometric measurements: tonsil size gradingup to 4 months

Tonsil size grading: 0, surgically removed tonsils; 1, tonsils hidden within the pillars; 2, tonsils extending to the pillars; 3, tonsils were beyond the pillars but not to the midline; and 4, tonsils extended to the midline.

Anthropometric measurements: modified Mallampati grade (aka updated Friedman's tongue positionup to 4 months

updated Friedman's tongue position: I: visualization of the entire uvula and tonsils/pillars.; IIa: visualization of most of the uvula, but the tonsils/pillars are absent.; IIb: visualization of the entire soft plate to the base of the uvula.; III: visualization of some of the soft palate, but the distal structures are absent.; IV: visualization of the hard palate only.

Apnea/hypopnea index (AHI)up to 4 months

AHI: total number of apneas and hypopneas per hour of electroencephalographic sleep.

Anthropometric measurements: body mass index z-score (BMI z-score)up to 4 months

BMI z-score: a measure of relative weight adjusted for the child's age and gender, and calculated by dividing the difference between the measured value and the mean by the standard deviation.

Snoring visual analogue scale (Snoring VAS)up to 4 months

Snoring VAS (Units on a Scale): 0-10, 0 = "no snoring noise" and 10 = "the loudest sound imaginable

Anthropometric measurements: uvular lengthup to 4 months

uvular length in centimeter

Trial Locations

Locations (1)

Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital

🇨🇳

Kaohsiung City, Taiwan

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