Pediatric OSAS: Oximetry can provide answers when polysomnography is not available

Kaditis, Athanasios G.; Kheirandish‐Gozal, Leila; Gozal, David

doi:10.1016/j.smrv.2015.05.008

Cited by 130 publications

(131 citation statements)

References 47 publications

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“…13 Similarly, nocturnal oximetry has become known as a simple, low-cost, and less intrusive alternative to PSG, RP, or HRP to help in childhood OSA diagnosis. 14,17 In the current study, our results suggest that automated analysis of singlechannel SpO 2 from unattended oximetry may be as accurate as HRP in the diagnosis of OSA.…”

Section: Discussionsupporting

confidence: 50%

“…[14][15][16] Recent systematic reviews have reported that oximetry can provide essential information about OSA when PSG is not accessible. 11,17 Most available studies have analyzed the blood oxygen saturation (SpO 2 ) profiles that were recorded during attended in-laboratory PSG.…”

Section: Introductionmentioning

confidence: 99%

“…17 Signal processing techniques provide useful tools to gain not only insights into the pathological mechanisms influencing biological recordings, but also to improve the diagnostic ability of single-channel recordings when searching for simplified approaches. In this study, we propose to apply genetic algorithms (GAs) in order to compose an optimum model derived from oximetry data in childhood OSA diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Automated Screening of Children With Obstructive Sleep Apnea Using Nocturnal Oximetry: An Alternative to Respiratory Polygraphy in Unattended Settings

Álvarez

Alonso-Álvarez

Gutiérrez‐Tobal

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: Nocturnal oximetry has become known as a simple, readily available, and potentially useful diagnostic tool of childhood obstructive sleep apnea (OSA). However, at-home respiratory polygraphy (HRP) remains the preferred alternative to polysomnography (PSG) in unattended settings. The aim of this study was twofold: (1) to design and assess a novel methodology for pediatric OSA screening based on automated analysis of at-home oxyhemoglobin saturation (SpO2), and (2) to compare its diagnostic performance with HRP. Methods: SpO2 recordings were parameterized by means of time, frequency, and conventional oximetric measures. Logistic regression models were optimized using genetic algorithms (GAs) for three cutoffs for OSA: 1, 3, and 5 events/h. The diagnostic performance of logistic regression models, manual obstructive apnea-hypopnea index (OAHI) from HRP, and the conventional oxygen desaturation index ≥ 3% (ODI3) were assessed. Results: For a cutoff of 1 event/h, the optimal logistic regression model significantly outperformed both conventional HRP-derived ODI3 and OAHI: 85.5% accuracy (HRP 74.6%; ODI3 65.9%) and 0.97 area under the receiver operating characteristics curve (AUC) (HRP 0.78; ODI3 0.75) were reached. For a cutoff of 3 events/h, the logistic regression model achieved 83.4% accuracy (HRP 85.0%; ODI3 74.5%) and 0.96 AUC (HRP 0.93; ODI3 0.85) whereas using a cutoff of 5 events/h, oximetry reached 82.8% accuracy (HRP 85.1%; ODI3 76.7) and 0.97 AUC (HRP 0.95; ODI3 0.84). Conclusions: Automated analysis of at-home SpO2 recordings provide accurate detection of children with high pretest probability of OSA. Thus, unsupervised nocturnal oximetry may enable a simple and effective alternative to HRP and PSG in unattended settings. Keywords: at-home respiratory polygraphy, automated pattern recognition, blood oxygen saturation, genetic algorithms, nocturnal oximetry Citation: Álvarez D, Alonso-Álvarez ML, Gutiérrez-Tobal GC, Crespo A, Kheirandish-Gozal L, Hornero R, Gozal D, Terán-Santos J, Del Campo F. Automated screening of children with obstructive sleep apnea using nocturnal oximetry: an alternative to respiratory polygraphy in unattended settings. J Clin Sleep Med. 2017;13(5):693-702.

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Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Automated Screening of Children With Obstructive Sleep Apnea Using Nocturnal Oximetry: An Alternative to Respiratory Polygraphy in Unattended Settings

Álvarez

Alonso-Álvarez

Gutiérrez‐Tobal

et al. 2017

Journal of Clinical Sleep Medicine

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“…Nocturnal pulse oximetry was performed on all of the children, including the controls, and desaturation was defined as a 4% or more SaO 2 decrement, and desaturation cluster was defined as 5 or more desaturation in a 10 to 30 minute period 16 . All of the subjects and controls underwent at least six-hour assessments with nocturnal pulse oximetry, and those patients with 3 or more clusters of desaturation, and a minimum of 3 desaturations below 90%, were defined as having OSAS 7 .…”

Section: Methodsmentioning

confidence: 99%

“…Although the medical history and physical examination are very important, in circumstances when polysomnography is unavailable, other objective testing is recommended, including nocturnal video recording, nocturnal oximetry, and ambulatory polysomnography 6 . Recently, nocturnal oximetry was defined as an easy to use and low-cost diagnostic test when polysomnography is not available 7 .…”

mentioning

confidence: 99%

Evaluation of choroidal thickness measurements in pediatric obstructive sleep apnea syndrome patients

Bayraktar

Şimşek

2017

Turk J Pediatr

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Choroidal vascular impairment and obstructive sleep apnea syndrome (OSAS) related disorders have been shown in adults, but there have been no investigations with regard to the choroidal thickness measurements in children with OSAS. Our aim was to investigate this relationship in the early childhood period, which correlates with OSAS peak incidence due to adenotonsillar enlargement. One-hundred and nine pediatric OSAS patients and 42 age-sex matched controls were enrolled in this study. Nocturnal pulse oximetry was used to define the OSAS patients. Demographic data like age, sex and body-mass index were recorded. All of the subjects underwent complete otolaryngologic and ophthalmologic examination including visual acuity, intraocular pressure, central corneal thickness, axial length and choroidal thickness measurements. Overall, the 1,000 µm and 1,500 µm nasal choroid measurements were found to be significantly lower in the patient group (p<0.05). However, only a poor inverse correlation emerged between the body-mass index (BMI) and the foveal center measurements in the patients. Observed alterations in the choroid may signify the initial impairment of known OSAS-related eye disorders, like glaucoma, floppy eyelid syndrome, and non-arteritic ischemic optic neuropathy. Ophthalmologists, otolaryngologists and pediatricians working together as a team may be able to prevent future eye diseases.

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Accuracy of clinical scoring tools for the diagnosis of pediatric obstructive sleep apnea

2019

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Objectives To assess the diagnostic test accuracy of questionnaire and clinical examination‐based scoring tools in the diagnosis of pediatric obstructive sleep apnea (OSA). Methods A comprehensive literature search was performed to identify studies published from 1960 to 2018 that evaluated the accuracy of clinical scoring tools in the diagnosis of pediatric OSA. Studies that did not include attended polysomnography as a reference standard were excluded. The study populations were children under 18 years old without craniofacial abnormalities, congenital syndromes, or other complex medical conditions. Outcomes measures were diagnostic test accuracy (DTA) statistics including sensitivity, specificity, and area under the curve (AUC) from receiver operating characteristic curve analysis. Results Fifteen different scoring tools were identified. Authors chose different polysomnographic criteria to diagnose OSA. Four of the tools had undergone multiple DTA studies by different authors (OSA Score, Sleep‐Related Breathing Disorder [SRBD] scale, Severity Score, and OSA‐18). The Pediatric Sleep Questionnaire SRBD scale, which is widely used, has a sensitivity of 71% to 84% in included studies, but specificity as low as 13% and a low AUC of 0.57‐0.69, indicating poor diagnostic accuracy. None of the 15 scoring tools performed well enough to be considered accurate diagnostic tests for pediatric OSA. Conclusions A well‐designed questionnaire can provide crucial information on the impact of sleep‐disordered breathing on a child's physical and psychological health, which may not be adequately reflected in objective polysomnography outcomes measures. However, DTA results indicate that published clinical scoring tools do not accurately predict a diagnosis of pediatric OSA as defined by polysomnography outcome measures. Laryngoscope, 130:1034–1043, 2020

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Pediatric OSAS: Oximetry can provide answers when polysomnography is not available

Cited by 130 publications

References 47 publications

Automated Screening of Children With Obstructive Sleep Apnea Using Nocturnal Oximetry: An Alternative to Respiratory Polygraphy in Unattended Settings

Automated Screening of Children With Obstructive Sleep Apnea Using Nocturnal Oximetry: An Alternative to Respiratory Polygraphy in Unattended Settings

Evaluation of choroidal thickness measurements in pediatric obstructive sleep apnea syndrome patients

Accuracy of clinical scoring tools for the diagnosis of pediatric obstructive sleep apnea

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