Correlation between REM AHI and Quality-of-Life Scores in Children with Sleep-Disordered Breathing

Abstract

Objectives Prior research has demonstrated poor correlation between the obstructive apnea-hypopnea index (AHI) on full-night polysomnogram (PSG) and quality-of-life (QOL) scores. We aim to examine the association between rapid eye movement (REM) AHI and QOL scores in children with sleep-disordered breathing (SDB). Study Design Prospective trial. Setting Two tertiary children’s hospitals. Subjects and Methods Children between 3 and 16 years of age with suspected SDB who were undergoing PSG were eligible. Children with craniofacial anomalies were excluded. Subjects’ caregivers completed the Obstructive Sleep Apnea–18 (OSA-18), a validated QOL survey. Power analysis determined a group size of 34. Results One hundred twenty-seven patients were enrolled. The mean (SD) age was 6.3 (3.3) years. Most subjects (52%) were black and 26% were obese. The mean (SD) obstructive AHI of the subject population was 5.4 (11.9), while the mean (SD) REM AHI was 13.1 (23.7). The mean total OSA-18 score was 65.2, indicating a moderate impact of SDB on QOL. Neither the obstructive AHI ( P = .73) nor the REM AHI ( P = .49) correlated with total OSA-18 scores. However, lower nadir oxygen saturation was associated with significantly poorer QOL ( P = .02). The sleep disturbance OSA-18 subset score significantly correlated with both the obstructive AHI ( r2 = 0.22; P = .01) and the REM AHI ( r2 = 0.22; P = .01); the remaining 4 subset scores did not correlate with either factor. Conclusion Neither obstructive AHI nor REM AHI correlates with total OSA-18 QOL scores. With the exception of nadir oxygen saturation, PSG parameters do not reflect the burden of SDB on QOL in children.