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OBJECTIVE: To determine the frequency of sleep problems in low-income, urban pediatric populations in cities at different altitudes in Colombia. METHODS: A descriptive, cross-sectional population-based observational study was conducted in children aged between 2 and 12 years in the low income, urban areas of three cities in Colombia (Santa Marta, Bucaramanga, and Bogotá) located at 15, 959, and 2640 m above sea level, respectively. Sociodemographic data were collected, and the Spanish version of the Pediatric Sleep Questionnaire was used. RESULTS: 1989 children were surveyed, distributed as follows: Santa Marta (32.0%), Bucaramanga (33.4%), and Bogotá (34.6%). The overall prevalence of sleep problems was 39.0%. Children from Santa Marta had the highest frequency of parasomnias (58.0%); those from Bucaramanga had the highest frequency of attention deficit symptoms (4.0%) and apneic pauses witnessed by parents or caregivers (5.7%). Finally, Bogotá, the only high-altitude location, had the highest frequency of sleep disordered breathing (17.2%). CONCLUSIONS: The study found a high frequency of sleep problems in the pediatric population, especially at higher altitudes when compared to lower altitude settings. Sleep disorders warrant early detection and timely therapeutic intervention.

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Introducción: La polisomnografía ha demostrado tener ciertas falencias en el diagnóstico del Síndrome de apnea-hipopnea obstructiva del sueño. Hay controversia respecto a las ayudas diagnósticas que requiere un paciente pediátrico antes de ser llevado a cirugía. Objetivo: Evaluar la utilidad diagnóstica de la fibronasolaringoscopia para detección de pacientes pediátricos con Síndrome de apnea-hipopnea obstructiva del sueño. Diseño: Estudio de pruebas diagnósticas.Materiales y métodos: Durante un año se realizaron 78 polisomnografías con igual número de fibronasolaringoscopias a pacientes pediátricos que por selección con encuestas podrían sugerir la presencia de un trastorno respiratorio del sueño. Se hizo posteriormente un análisis estadístico. Resultados: Encontramos una baja correlación entre los resultados con una sensibilidad del 71% y una especificidad del 62%. Sin embargo, la fibronasolaringoscopia presenta un valor predictivo negativo del 95%, que podría sugerir que las fibronasolaringoscopias normales se relacionan con una polisomnografía normal y ausencia de esta enfermedad. Conclusión: La fibronasolaringoscopia debe tomarse como una ayuda diagnóstica en casos de pobre correlación paraclínica-clínica y en pacientes sometidos a cirugía sin adecuada respuesta al manejo

Introduction: Polysomnography has shown to have certain shortcomings in the diagnosis of Obstructive Sleep Apnea syndrome. There is controversy regarding the appropriate workup required for pediatric patients when considering surgical treatment. Objective: To evaluate the diagnostic value of flexible nasolaryngoscopy in a pediatric population with Obstructive Sleep Apnea syndrome. Design: Diagnostic accuracy study. Methods: We included seventy-eight children with clinical suspicion of Obstructive Sleep Apnea, accordingly to a screening standard questionnaire. All children underwent polysomnography and flexible nasolaryngoscopy. Appropriate statistical analysis was performed. Results: We found a low correlation between polysomnography and flexible nasolaryngoscopy results. Flexible nasolaryngoscopy showed a sensitivity of 71% and a specificity of 62%, with a negative predictive value of 95%, indicating that a normal flexible nasolaryngoscopy correlates with a normal polysomnography. Conclusions: Flexible nasolaryngoscopy should be performed in cases with poor correlation between polysomnography results and clinical findings, and in all children with inadequate response to surgical treatment.

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