期刊
SLEEP MEDICINE
卷 54, 期 -, 页码 159-163出版社
ELSEVIER
DOI: 10.1016/j.sleep.2018.09.032
关键词
Obstructive sleep apnea; Electrocardiography; Arrhythmia; Children
资金
- Ramathibodi Research Grant, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Introduction: The gold standard for the diagnosis of childhood obstructive sleep apnea syndrome (OSAS) diagnosis is polysomnography; however, electrocardiography (ECG) may provide a simpler alternative. P-wave dispersion (PWD), the difference between the maximum and minimum P-wave duration measured by 12-lead ECG, is increased in adult OSAS but has not been researched in childhood OSAS. The aims of this study were to determine the PWD and cut-off value for the diagnosis of childhood OSAS and its association with severity. Methods: A total of 77 children with confirmed OSAS and 44 control participants underwent surface 12-lead ECG. P-wave duration was measured using a digital caliper by a researcher blinded to the groups. Results: Median (interquartile range) PWD in children with OSAS (median age = 82.8 months, range = 24-194 months) was significantly higher than that in the control group (median age = 73.4 months, range = 12-156 months): 38.3 (29.7-50.5) vs 25.5 (20.5-30.5) milliseconds, respectively (p < 0.0001). Subgroup analysis according to OSAS severity categorized by the apnea-hypopnea index from polysomnography demonstrated that PWD in the severe OSAS group (n = 24) was significantly higher than that in the mild-to-moderate OSAS group (n = 53): 48.5 (34.7-67.4) vs 35.5 (28.2-47.8) milliseconds, respectively (p = 0.006). A cut-off value of PWD at 26.5 ms from the receiver operating characteristic curve for the diagnosis showed the area under the curve to be 0.839, with a sensitivity of 89.6% and a specificity of 61.4%. Conclusion: PWD was significantly increased in children with OSAS, particularly in severe cases. PWD could be a useful tool for screening childhood OSAS. (c) 2018 Elsevier B.V. All rights reserved.
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