Somnoscreen plus device

A medical history, including comorbidities, was taken, and physical examinations, including height and weight measurements, were performed. The diagnosis of OSA was based on overnight polysomnography using a Somnomedics Somnoscreen plus device (Somnomedics, Randersacker, Germany) [2 (link), 19 (link)]. Apnoeas and hypopneas were analysed, and AHI was determined as the total number of apnoeas and hypopneas per hour of sleep. The desaturation index (DI), i.e., the number of periods with desaturation per hour (i.e., a minimum 4% decrease in oxygen saturation), was also calculated [20 (link), 21 (link)]. In addition, the minimum oxygen saturation level (min. SpO₂) was also obtained. The diagnostic criteria of the American Academy of Sleep Medicine defined paediatric OSA diagnosis as AHI ≥ 1 [22 (link)]. In the present study, OSA was classified as mild (1 ≤ AHI < 5), moderate (5 ≤ AHI < 10), and severe (AHI ≥ 10) [23 (link)].

The study was performed using the Somnomedics SOMNOscreen plus device (Somnomedics) according to the guideline. Polygraphic readings were evaluated by a physician experienced in sleep medicine. Breathing irregularities (apneas and hypopneas) were analyzed and Apnea–Hypopnea Index (AHI) was presented as the number of apneas and hypopneas per sleeping hour. The desaturation index indicates the number of periods with desaturation (minimum of 3% fall in oxygen saturation) per hour. According to the polysomnographic diagnostic criteria for childhood OSA by Marcus et al. [1 (link)] one episode of apnea during sleep is considered pathologic. The respiratory pause has to last for at least two breaths to be considered abnormal. In hypopnea, the respiratory amplitude is reduced by at least 30% and occurs when the oxygen saturation drops by 3%. We classified the severity of OSAS as mild, AHI = 1 event/hour with desaturation or AHI 2–5 event/hour; moderate, 5 < AHI > 10 event/hour; and severe AHI > 10 event/hour [31 (link)].