Obstructive Sleep Apnea (OSAS) in a clinical cohort of children. Atlantis Study

Aim: To evaluate the succes rate of surgical treatment and residual OSAS in a cohort of children Methods: We performed an observational, longitudinal, ambispectives study in children referred to the Sleep Unit from 2000 to 2010. In all children included, we performed a clinical history, physical and otorhinolaryngology examination and Nocturnal Polysomnography (NPSG) or Nocturnal Polygraphy (NRP). Obstructive apnea/Hypopnea index (OAHI)≥3 on NPSG and respiratory disturbances index (RDI)≥4.6 on NRP were taken as diagnosis of OSAS. Results: 1139 children were estudied, 672 boys and 467 girls. The average age was 4.85±3.07 years and the average Body Mass Index (BMI) percentile was 52.84±32.39. For the diagnosis, we used NPSG in (50.1%) and NRP in (49.9%) of children included. Snoring and respiratory pauses were reported in 85.9% and 56.9%; Hyperactivity, sleepiness and irritability were reported in 25.5%, 21.8% and 9.2%. 738 (64.8%) of children were diagnosed of OSAS, with an RDI of 9.5±12.6. There were no differences in sex between the OSAS and nonOSAS groups, but there were statistically significant differences in age, weight, neck circunference and BMI. Surgical treatment was performed in 559(75.7%) of OSAS. The success rate was 73.9%; 95% CI:69.01%-78.84% with a statiscally significant improvement in all of clinical and respiratory variables. The prevalence of residual OSAS was 26.1%. In the binary logistic regression model, age BMI, high hard palate and adenotonsillar hypertrophy emerged as a significant risk factors for OSAS. Conclusions: The persistence of disease (26.1%), in spite of treatment, it makes neccessary to follow-up and perform sleep control studies. Funded by SEPAR and FIS