ABSTRACT
A recent meta-analysis revealed that only 55% of all children suspected to have obstructive sleep apnea (OSA) by clinical evaluation had OSA confirmed by polysomnography (PSG). The simplest diagnostic tool for a parent is to place a tape recorder in the child’s room and press “record.” If the objective is to identify snoring, an audiotape is helpful. Cessation of snoring could be an apnea or resumption of breathing. Videotaping is occasionally utilized by parents “to capture” their concerns regarding their child’s breathing pattern at night. Once again, the test is nonquantitative. Oximetry would have a greater role in the diagnosis of OSA if all obstructive respiratory events were associated with oxygen desaturations. An ambulatory or unattended portable PSG, which is performed in a child’s own bedroom, would be the ideal setting to evaluate sleep problems. Peripheral arterial tonometry is a new tool to detect the disruption of the sleep architecture.
