Aims: To assess the presence of a first night effect (FNE) in children and adolescents and to examine if a single night polysomnography (PSG) is sufficient for diagnosing obstructive sleep apnoea syndrome (OSAS).
Methods: Prospective case study of 70 patients (group 1: 2–6 years, n = 22; group 2: 7–12 years, n = 32; group 3: 13–17 years, n = 16) referred for OSAS. Diagnostic criteria for OSAS: one or more of the following: (1) obstructive apnoea index (OAI) ⩾1; (2) obstructive apnoea hypopnoea index (oAHI) ⩾2; (3) SaO2 ⩽89% in association with obstruction.
Results: In all age groups, but mainly in the oldest children, REMS increased during the second night, mainly at the expense of stage 2 sleep. The first night PSG correctly identified OSAS in 86%, 91%, and 100% of the children for groups 1, 2, and 3 respectively. This represents 9% false negatives for OSAS when only the first night PSG was used. All cases missed had mild OSAS, except for one with oAHI >5 on night 2. There were also seven patients with OSAS on night 1 but with a normal PSG on night 2: all had oAHI <5.
Conclusion: There is a FNE in children and adolescents. A single night PSG is sufficient for diagnosing OSAS, but in cases with a suggestive history and examination and with a negative first night, a second night study might be advisable.
- AHI, apnoea hypopnoea index
- FNE, first night effect
- OAI, obstructive apnoea index
- oAHI, obstructive apnoea hypopnoea index
- OSAS, obstructive sleep apnoea syndrome
- PS, primary snoring
- PSG, polysomnography
- REML, REM sleep latency
- REMS, rapid eye movement sleep
- SL, sleep latency
- SaO2, oxygen saturation
- SDB, sleep disordered breathing
- SPT, sleep period time
- TIB, time in bed
- TST, total sleep time
- first night effect
- obstructive sleep apnoea
- sleep disordered breathing
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