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Sleep Med Res > Volume 13(1); 2022 > Article
Sleep Medicine Research 2022;13(1): 31-37.
doi: https://doi.org/10.17241/smr.2022.01277
Verification for Diagnosis of Sleep-Related Hypoventilation and Carbon Dioxide Partial Pressure During Sleep in Children Using End-Tidal Carbon Dioxide
Jang Gyu Han MD1 , Hannah Park MD1 , Ji Sun Yang MD1 , Ji Su Kim BS2 , Bumhee Park PhD2,3 , Do-Yang Park MD, PhD1,4 , Hyun Jun Kim MD, PhD1,4
1Department of Otolaryngology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
2Biostatics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
3Department of Biomedical Informatics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
4Sleep Center, Ajou University Hospital, Suwon, Korea
Corresponding Author: Hyun Jun Kim ,Tel: +82-31-219-5138, Fax: +82-31-219-5264, Email: entkhj@ajou.ac.kr
Received: April 23, 2022.  Revised: June 8, 2022.  Accepted: June 12, 2022.
Abstract
Background and Objective     From the past, several researchers have studied and measured the partial pressure of carbon dioxide during sleep in normal children to establish diagnostic criteria for hypoventilation in children. Here we tried to verify the existing definition of sleep-related hypoventilation in Asian by evaluating and analyzing the carbon dioxide partial pressure in pediatric subjects who underwent polysomnography.
Methods     We retrospectively analyzed clinical information of 196 children who underwent polysomnography at our hospital from Feb 2011 to Apr 2021. Among Asian pediatric subjects, those with serious chronic or genetic diseases, craniofacial deformities, and hypoventilation confirmed by polysomnography were excluded. We evaluated partial pressure of carbon dioxide in target group by end-tidal carbon dioxide (EtCO2) measured with a stream capnometer through nasal cannula. The target group was classified by apnea-hypopnea index and analyzed.
Results     The mean value of the time with EtCO2 ≥ 45 mm Hg in total sleep time was 47.00% which is higher than previous studies. The mean value of the time with EtCO2 ≥ 50 mm Hg in total sleep time was 2.77% which is similar to previous studies. Also, our subjects showed the highest mean EtCO2 value in non-rapid eye movement (NREM) stage and lowest mean EtCO2 value when wake.
Conclusions     In this study, the diagnostic criteria for sleep-related hypoventilation at the American Academy of Sleep Medicine (AASM) in 2017 established by measuring the EtCO2 in western children seems appropriate to apply to Asian children to define hypoventilation.
Key Words: Sleep-related hypoventilation; End-tidal carbon dioxide; Sleep stages; Polysomnography; Carbon dioxide
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