Pediatric Obstructive Sleep-Disordered Breathing

Updated Polysomnography Practice Patterns

Norman R. Friedman, Amanda G. Ruiz, Dexiang Gao, Alexandria Jensen, Ron B Mitchell

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To assess the current practice patterns of pediatric otolaryngologists in managing obstructive sleep-disordered breathing 6 years following the 2011 publication of the clinical practice guideline “Polysomnography for Sleep-Disordered Breathing prior to Tonsillectomy in Children.” Study Design: Cross-sectional survey. Setting: American Society of Pediatric Otolaryngology (ASPO) members. Subjects and Methods: An electronic survey to assess ASPO members’ adherence to polysomnography guidelines prior to tonsillectomy. Results: Forty percent (170 of 427) of ASPO members completed the survey, with 73% in academic practice and 27% in private practice. Snoring represented, on average, 48% of the respondents’ practices. The percentage of respondents who requested a polysomnogram prior to tonsillectomy ≥90% of the time was 55% (n = 94) for Down syndrome, 41% (n = 69) for a child <2 years old, and 29% (n = 49) for obese children. A total of 109 (73%) and 112 (75%) respondents admit at least 90% of the time for a child with Down syndrome and for a child <3 years of age, respectively, but only 52 (35%) have a similar practice for an obese child. Only 37% adhere to the inpatient admission recommendation for children with documented obstructive sleep apnea on polysomnogram. Conclusion: The current polysomnogram practice patterns for responding pediatric otolaryngologists are not aligned with the clinical practice guideline of the American Academy of Otolaryngology—Head and Neck Surgery Foundation. The threshold for overnight observation when a preoperative polysomnogram has not been performed may be too low. A campaign is necessary to educate clinicians who take care of children with obstructive sleep-disordered breathing and to obtain more evidence to further define best practice.

Original languageEnglish (US)
JournalOtolaryngology - Head and Neck Surgery (United States)
DOIs
StatePublished - Jan 1 2019

Fingerprint

Polysomnography
Sleep Apnea Syndromes
Pediatrics
Tonsillectomy
Otolaryngology
Practice Guidelines
Down Syndrome
Snoring
Private Practice
Obstructive Sleep Apnea
Child Care
Publications
Inpatients
Neck
Cross-Sectional Studies
Observation
Surveys and Questionnaires
Guidelines

Keywords

  • ASPO
  • child
  • otolaryngology
  • polysomnography
  • practice guidelines as topic
  • sleep apnea syndromes
  • surveys and questionnaires
  • tonsillectomy

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Pediatric Obstructive Sleep-Disordered Breathing : Updated Polysomnography Practice Patterns. / Friedman, Norman R.; Ruiz, Amanda G.; Gao, Dexiang; Jensen, Alexandria; Mitchell, Ron B.

In: Otolaryngology - Head and Neck Surgery (United States), 01.01.2019.

Research output: Contribution to journalArticle

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title = "Pediatric Obstructive Sleep-Disordered Breathing: Updated Polysomnography Practice Patterns",
abstract = "Objective: To assess the current practice patterns of pediatric otolaryngologists in managing obstructive sleep-disordered breathing 6 years following the 2011 publication of the clinical practice guideline “Polysomnography for Sleep-Disordered Breathing prior to Tonsillectomy in Children.” Study Design: Cross-sectional survey. Setting: American Society of Pediatric Otolaryngology (ASPO) members. Subjects and Methods: An electronic survey to assess ASPO members’ adherence to polysomnography guidelines prior to tonsillectomy. Results: Forty percent (170 of 427) of ASPO members completed the survey, with 73{\%} in academic practice and 27{\%} in private practice. Snoring represented, on average, 48{\%} of the respondents’ practices. The percentage of respondents who requested a polysomnogram prior to tonsillectomy ≥90{\%} of the time was 55{\%} (n = 94) for Down syndrome, 41{\%} (n = 69) for a child <2 years old, and 29{\%} (n = 49) for obese children. A total of 109 (73{\%}) and 112 (75{\%}) respondents admit at least 90{\%} of the time for a child with Down syndrome and for a child <3 years of age, respectively, but only 52 (35{\%}) have a similar practice for an obese child. Only 37{\%} adhere to the inpatient admission recommendation for children with documented obstructive sleep apnea on polysomnogram. Conclusion: The current polysomnogram practice patterns for responding pediatric otolaryngologists are not aligned with the clinical practice guideline of the American Academy of Otolaryngology—Head and Neck Surgery Foundation. The threshold for overnight observation when a preoperative polysomnogram has not been performed may be too low. A campaign is necessary to educate clinicians who take care of children with obstructive sleep-disordered breathing and to obtain more evidence to further define best practice.",
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N2 - Objective: To assess the current practice patterns of pediatric otolaryngologists in managing obstructive sleep-disordered breathing 6 years following the 2011 publication of the clinical practice guideline “Polysomnography for Sleep-Disordered Breathing prior to Tonsillectomy in Children.” Study Design: Cross-sectional survey. Setting: American Society of Pediatric Otolaryngology (ASPO) members. Subjects and Methods: An electronic survey to assess ASPO members’ adherence to polysomnography guidelines prior to tonsillectomy. Results: Forty percent (170 of 427) of ASPO members completed the survey, with 73% in academic practice and 27% in private practice. Snoring represented, on average, 48% of the respondents’ practices. The percentage of respondents who requested a polysomnogram prior to tonsillectomy ≥90% of the time was 55% (n = 94) for Down syndrome, 41% (n = 69) for a child <2 years old, and 29% (n = 49) for obese children. A total of 109 (73%) and 112 (75%) respondents admit at least 90% of the time for a child with Down syndrome and for a child <3 years of age, respectively, but only 52 (35%) have a similar practice for an obese child. Only 37% adhere to the inpatient admission recommendation for children with documented obstructive sleep apnea on polysomnogram. Conclusion: The current polysomnogram practice patterns for responding pediatric otolaryngologists are not aligned with the clinical practice guideline of the American Academy of Otolaryngology—Head and Neck Surgery Foundation. The threshold for overnight observation when a preoperative polysomnogram has not been performed may be too low. A campaign is necessary to educate clinicians who take care of children with obstructive sleep-disordered breathing and to obtain more evidence to further define best practice.

AB - Objective: To assess the current practice patterns of pediatric otolaryngologists in managing obstructive sleep-disordered breathing 6 years following the 2011 publication of the clinical practice guideline “Polysomnography for Sleep-Disordered Breathing prior to Tonsillectomy in Children.” Study Design: Cross-sectional survey. Setting: American Society of Pediatric Otolaryngology (ASPO) members. Subjects and Methods: An electronic survey to assess ASPO members’ adherence to polysomnography guidelines prior to tonsillectomy. Results: Forty percent (170 of 427) of ASPO members completed the survey, with 73% in academic practice and 27% in private practice. Snoring represented, on average, 48% of the respondents’ practices. The percentage of respondents who requested a polysomnogram prior to tonsillectomy ≥90% of the time was 55% (n = 94) for Down syndrome, 41% (n = 69) for a child <2 years old, and 29% (n = 49) for obese children. A total of 109 (73%) and 112 (75%) respondents admit at least 90% of the time for a child with Down syndrome and for a child <3 years of age, respectively, but only 52 (35%) have a similar practice for an obese child. Only 37% adhere to the inpatient admission recommendation for children with documented obstructive sleep apnea on polysomnogram. Conclusion: The current polysomnogram practice patterns for responding pediatric otolaryngologists are not aligned with the clinical practice guideline of the American Academy of Otolaryngology—Head and Neck Surgery Foundation. The threshold for overnight observation when a preoperative polysomnogram has not been performed may be too low. A campaign is necessary to educate clinicians who take care of children with obstructive sleep-disordered breathing and to obtain more evidence to further define best practice.

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