Home oximetry to screen for obstructive sleep apnoea in Down syndrome

Hill, Catherine M.; Elphick, Heather; Farquhar, Michael; Gringras, Paul; Pickering, Ruth; Kingshott, Ruth; Martin, Jane; Reynolds, Janine; Joyce, Anna; Gavlak, Johanna; Evans, Hazel

doi:10.1136/archdischild-2017-314409

Cited by 30 publications

(21 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This has the potential to greatly reduce the number of children needing full PSG in order to make the diagnosis. 94 The treatment of OSA in children remains difficult. AAP recommends adenotonsillectomy in first instance for all children with OSA and tonsillar hypertrophy.…”

Section: Respiratory Problemsmentioning

confidence: 99%

Multiorgan involvement and management in children with Down syndrome

et al. 2020

View full text Add to dashboard Cite

show abstract

Section: Respiratory Problemsmentioning

confidence: 99%

Multiorgan involvement and management in children with Down syndrome

et al. 2020

View full text Add to dashboard Cite

show abstract

“…3 Oxygen saturation studies (pulse oximetry), sometimes recorded with a measure of pCO 2 (oxicapnography), cannot be used to diagnose SDB, but are used for screening and risk assessment in some circumstances. 4,5 The limited population-based normative data, lack of consensus regarding respiratory event scoring parameters between full PSG and limited channel studies, and changes in standards over time 6,7,8 have been significant barriers to description of respiration in normal sleep in infants, 9,10 children 11,12 and adults. 13,14 However, the American Academy of Sleep Medicine (AASM) now have consensus definitions for scoring polysomnographic studies, [6][7][8] and overnight oximetry, particularly for mean or median across the whole night.…”

Section: Normal Respiratory Physiology In Sleepmentioning

confidence: 99%

<p>Sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton</p>

Brennan

Kirkham

Gavlak

2020

NSS

Self Cite

View full text Add to dashboard Cite

Obstructive sleep-disordered breathing (SDB), which includes primary snoring through to obstructive sleep apnea syndrome (OSAS), may cause compromise of respiratory gas exchange during sleep, related to transient upper airway narrowing disrupting ventilation, and causing oxyhemoglobin desaturation and poor sleep quality. SDB is common in chronic disorders and has significant implications for health. With prevalence rates globally increasing, this condition is causing a substantial burden on health care costs. Certain populations, including people with sickle cell disease (SCD), exhibit a greater prevalence of OSAS. A review of the literature provides the available normal polysomnography and oximetry data for reference and documents the structural upper airway differences between those with and without OSAS, as well as between ethnicities and disease states. There may be differences in craniofacial development due to atypical growth trajectories or extramedullary hematopoiesis in anemias such as SCD. Studies involving MRI of the upper airway illustrated that OSAS populations tend to have a greater amount of lymphoid tissue, smaller airways, and smaller lower facial skeletons from measurements of the mandible and linear mental spine to clivus. Understanding the potential relationship between these anatomical landmarks and OSAS could help to stratify treatments, guiding choice towards those which most effectively resolve the obstruction. OSAS is relatively common in SCD populations, with hypoxia as a key manifestation, and sequelae including increased risk of stroke. Combatting any structural defects with appropriate interventions could reduce hypoxic exposure and consequently reduce the risk of comorbidities in those with SDB, warranting early treatment interventions.

show abstract

“…8 Recently the DSI 3% has been reported as being useful in screening children with Down syndrome for obstructive sleep apnea when compared with PSG. 25 With regard to the reporting of both 3% and 4% DSI, we believe that to use two very similar definitions of IH serves to highlight the effect of variation in definition on the documentation of IH events.…”

Section: Discussionmentioning

confidence: 99%

Intermittent hypoxia in preterm infants: Measurement using the desaturation index

Wellington¹,

Campbell²,

Elder³

2019

Pediatric Pulmonology

View full text Add to dashboard Cite

Objective The aims of this study were to: (i) Determine in preterm infants at neonatal discharge the prevalence of intermittent hypoxia (IH), as measured by the oxygen desaturation index (DSI) recorded by pulse oximetry and (ii) Determine the change in values for very preterm infants at 1‐month post discharge. Methods Preterm infants were recruited from the Wellington regional neonatal intensive care unit (NICU) and 24‐h pulse oximetry recordings performed immediately before discharge. Infants born <32 weeks gestational age (GA) had repeat oximetry 1‐month post discharge. Oxygenation measures included the 3% and 4% desaturation (DSI 3%, DSI 4%) indices. Results At discharge from the neonatal unit the median and interquartile range (IQR) for DSI 4% was 51 (31‐74) events per hour with normal mean SpO2 (median of 97.9% [97.2‐98.8 IQR]). Episodes of IH 1 month post discharge decreased with improvements of between 42% and 57% seen for the three DSI measures. Infants <32 weeks GA had higher median DSI 3 and 4% values at discharge but differences when compared with late preterm infants were not significant. Conclusions Preterm infants have frequent episodes of IH as measured by the 3% and 4% DSI when deemed otherwise ready for discharge home. Further research in a larger cohort of very preterm infants and also in term infants is needed to determine the significance of this finding.

show abstract

Home oximetry to screen for obstructive sleep apnoea in Down syndrome

Cited by 30 publications

References 27 publications

Multiorgan involvement and management in children with Down syndrome

Multiorgan involvement and management in children with Down syndrome

<p>Sleep-disordered breathing and comorbidities: role of the upper airway and craniofacial skeleton</p>

Intermittent hypoxia in preterm infants: Measurement using the desaturation index

Contact Info

Product

Resources

About