MOVEMENT AROUSALS - DESCRIPTION, CLASSIFICATION, AND RELATIONSHIP TO SLEEP-APNEA IN CHILDREN

Movement/arousal has been described as a characteristic of adult obstr uctive sleep apnea syndrome (OSAS), but opinions differ as to whether or not OSAS in children increases the frequency of movement/arousal. T he problem that we decided to address was the lack of a comprehensive definition and characterization of movement/arousals in children. We t herefore quantified and classified movement/arousals during nocturnal polysomnography in 15 children 5.2 +/- 2.7 SD yr of age being evaluate d for OSAS. Movement/arousals were defined by modifying the standard c riteria for scoring arousals in adults. Median respiratory disturbance index was 4.4/h, with a range of 1 to 28/h. Videotape review was requ ired to adequately distinguish technician-induced from spontaneous mov ement/arousals. Although movement/arousal durations varied from 1 s to prolonged awakenings, a high frequency of brief, 1- to 3-s movement/a rousals occurred in all classification categories: respiratory, 44%; t echnician-induced, 33%; spontaneous, 36%. When comparing a 16-channel PSG montage with that of a seven-channel cardiorespiratory montage, we found that 84% of all movement/arousals could be detected using the a bbreviated montage. In conclusion, we propose a simple classification system that distinguishes th ree types of movement/arousals: respirato ry, technician-induced, and spontaneous. Our results further suggest t hat a simple montage using cardiorespiratory channels and videotaping would be suitable for home study and sensitive for identifying movemen t/arousals.