Normal values for sleep respiratory poligraphy in children 4-9 years old living at 2,560 meters above sea level

Abstract

Introduction: Obstructive sleep apnea (OSA) syndrome affects 1-10% of all children worldwide. Normal sleep parameters are important in children 4-9 years old because in this group adenotonsillar hypertrophy is a common cause of OSA. Currently, OSA diagnosis is based on sea-level guidelines, without taking into account the altitude at which the populations live; however, it has been shown that at 3,200 m of altitude there is an increase in obstructive events in healthy children aged 7-16 years; on the other hand, it is known that SpO2 dispersion between individuals becomes wider as altitude increases, a phenomenon that is more marked during sleep. About 17 million Colombians live in regions between 2,500 m to 2,700 m, as well as significant populations in other Latin American countries.

Objectives: We aimed this research to knowing polygraphy respiratory sleep parameters in healthy, non-snoring children aged 4 to 9 years living at 2,560 m. Methods: Home respiratory polygraphy was carried out in 32 children healthy non snoring children with a mean age of 6.2 years.

Results: The average recorded sleep time was 7.8 hours, the median of apnea-hypopnea index was 9.2/hour, the obstructive apnea-hypopnea index had a median of 8.8/hour and the central apnea a median of 0.4/hour. The median of oxygen desaturation index ≥3% was 11.2 and for oxygen desaturation index ≥4% was 3.9.

Conclusions: Normal respiratory sleep parameters in children 4 to 9 years of age are much higher at 2,560 m than those established as normal at sea level. If such guidelines are used, obstructive sleep apnea will be over-diagnosed, resulting in unnecessary adenotonsillectomies, among other interventions.