NORMAL POLYSOMNOGRAPHIC VALUES FOR CHILDREN AND ADOLESCENTS

Although polysomnography is routinely performed to evaluate children and adolescents cents with sleep-disordered breathing, normal polysomnographic values for the pediatric age group have not yet been established. We therefore performed overnight polysomnography in 50 normal children and adolescents (mean age 9.7 +/- 4.6 SD yr, range 1.1 to 17.4 yr). Of the children 56% were male. Chest wall motion, ECG, oronasal airflow, end-tidal PCO2 (PET(CO2)), arterial oxygen saturation (Sa(O2)), and electrooculogram were monitored. Children had 0.1 +/- 0.5 (range 0 to 3.1) obstructive apneas per hour of total sleep time, with only 18% of children having any obstructive apneas. No child had obstructive apneas > 10 s in duration. Of the children 30% had central apneas greater-than-or-equal-to 10 s in duration, and one child had a central apnea associated with Sa(O2) < 90%. Peak PET(CO2) was 46 +/- 4 mm Hg (range 38 to 53 mm Hg), and hypoventilation (PET(CO2) > 45 mm Hg) occurred for 7 +/- 19% total sleep time (range 0 to 91%). The Sa(O2) nadir was 96 +/-2% (range 89 to 98%), with only one child desaturating below 90% in association with a central apnea. We conclude that polysomnographic results in the pediatric age group differ from those in adults. Recommendations for normal polysomnographic criteria are given.