Study Objectives: To assess the incidence of polysomnographically defined obstructive
sleep apnea (OSA) in pediatric psychiatric clinic patients reporting daytime sleepiness
on questionnaire, and to identify diagnostic correlates for OSA in this grouping.
Design: Prospective and observational. Setting: Outpatient pediatric psychiatry clinic,
outpatient sleep medicine clinic, AASM-accredited hospital-based sleep laboratory.
Subjects: Children aged 3 to 16 years, reporting daytime sleepiness on questionnaire
(N = 74); exclusions: adenotonsillectomy and trisomy 21. Interventions: Parents and
children completed a questionnaire designed and validated for identifying pediatric
patients with OSA at the pediatric psychiatry clinic. Patients with at least one positive
response as to daytime sleepiness (N = 74) were referred for a history and physical by a board-certified sleep medicine
physician before in-hospital polysomnography utilizing a routine apnea montage with
parent or legal guardian sleeping in room. Results: Mean apnea-hypopnea index (AHI)
for this pediatric psychiatry clinic grouping was 5.5. Of these patients, 39.2% had
an AHI > 5.0. Mean AHI for patients with attention deficit/hyperactivity disorder
(AD/HD) was 7.1; without AD/HD it was 4.5 (p < 0.05). Mean AHI for patients with tonsillar hypertrophy was 6.5 compared with 4.4
for those without tonsillar hypertrophy (p < 0.05). Conclusion: In a clinical grouping of pediatric psychiatry patients reporting
daytime sleepiness by questionnaire, polysomnographically defined OSA is common. Both
AD/HD as diagnosed using DSM-IV criteria and tonsillar hypertrophy based on clinical
exam by a sleep medicine physician are diagnostic correlates for polysomnographically
defined OSA in this pediatric psychiatry clinic grouping of patients.
KEYWORDS
AD/HD - OSA - pediatrics - sleepiness - tonsillar hypertrophy
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Rocky Mt. Sleep, 1619 N. Greenwood
Pueblo, CO 81003
Email: pueo34@aculink.com
