Aim: Polysomnography (PSG) is the gold standard for diagnosing Obstructive Sleep Apnoea (OSA). In the UK the diagnosis and decision to proceed to adenotonsillectomy is usually clinical as PSG is not widely available. The Sleep Service at our centre provides limited-channel cardiorespiratory sleep studies (SS) for children with suspected OSA. This affords categorisation of OSA severity and informs the need for a high dependency unit (HDU) bed post-operatively. This audit reviews SS outcomes at our centre and their impact on operative management and use of HDU beds. Method: Retrospective analysis of non-syndromic children without comorbidities who had limited-channel cardiorespiratory SS at our centre from January 2009 to December 2012. Results: 271 children were included. In 45% (n=121) SS showed no evidence of OSA. 30% of all children (n=80) did not proceed to adenotonsillectomy on this basis. Of 191 children undergoing adenotonsillectomy, SS informed a request for a HDU bed in 17 (8.9%). Only 5 children (2.6%) had post-operative airway sequelae which warranted HDU care. Conclusion: Cardiorespiratory sleep studies appears to help avoid unnecessary surgery in 30% of children. This requires further analysis. The low rate of airway sequelae suggests HDU care is probably only indicated in cases of severe OSA.
Vaughan, E., Urquhart, D., Montague, M.-L., Stirrat, N., Fynn, D., & Sharma, A. (2013). Perioperative management of paediatric obstructive sleep apnoea. International Journal of Surgery, 11(8), 640. https://doi.org/10.1016/j.ijsu.2013.06.285