Reliability of Home Respiratory Polygraphy for the Diagnosis of Sleep Apnea in Children

Abstract

OBJECTIVE:Th e objective of this study was to evaluate the diagnostic reliability of home respiratory polygraphy (HRP) in children with a clinical suspicion of OSA-hypopnea syndrome (OSAS). METHODS:A prospective blind evaluation was performed. Children between the ages of 2 to 14 years with clinical suspicion of OSAS who were referred to the Sleep Unit were included. An initial HRP followed by a later date , same night, in-laboratory overnight respiratory polygraphy and polysomnography (PSG) in the sleep laboratory were performed. Th e apneahypopnea index (AHI)-HRP was compared with AHI-PSG, and therapeutic decisions based on AHI-HRP and AHI-PSG were analyzed using intraclass correlation coeffi cients, BlandAltman plots, and receiver operator curves (ROCs). RESULTS:Twenty-seven boys and 23 girls, with a mean age of 5.3 Ϯ 2.5 years, were studied, and 66% were diagnosed with OSAS based on a PSG-defi ned obstructive respiratory disturbance index Ն 3/h total sleep time. Based on the availability of concurrent HRP-PSG recordings, the optimal AHI-HRP corresponding to the PSG-defi ned OSAS criterion was established as Ն 5.6/h Th e latter exhibited a sensitivity of 90.9% (95% CI, 79.6%-100%) and a specifi city of 94.1% (95% CI, 80%-100%).CONCLUSIONS: HRP recordings emerge as a potentially useful and reliable approach for the diagnosis of OSAS in children. However, more research is required for the diagnosis of mild OSAS using HRP in children. ENT 5 ear, nose, and throat; HRP 5 home respiratory polygraphy; ICC 5 interclass correlation coeffi cient; LRP 5 in-laboratory respiratory polygraphy; OAHI 5 obstructive apnea-hypopnea index; ORDI 5 obstructive respiratory disturbance index; OSAS 5 OSAhypopnea syndrome; PSG 5 polysomnography; RDI 5 respiratory disturbance index; ROC 5 receiver operating characteristic; RP 5 respiratory polygraphy; Sp o 2 5 oxygen saturation using pulse oximetry; SU 5 Sleep Unit AFFILIATIONS: From the Sleep Unit (Drs Alonso-Álvarez, Terán-Santos, Ordax Carbajo, Cordero-Guevara, and Navazo-Egüia), the CIBER of Respiratory Diseases (Drs Alonso-Álvarez and Terán-Santos), Instituto Carlos III, CIBERES, and the

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

“…4,11,13 However, RP-based approaches have become increasingly accepted as an effective diagnostic method when carried out in a clinical setting both in adults and children. 11,37 Furthermore, ambulatory HRP has been considered a feasible means of diagnosing OSA when PSG is not available, according to a recent report of the European Respiratory Society.…”

“…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.…”

“…11 A recent study demonstrated the feasibility of HRP to evaluate children with OSA at home. 13 Nocturnal oximetry has long been proposed as a screening tool for pediatric OSA in high-risk patients due to its reliability, simplicity, and suitability for children. [14][15][16] Recent systematic reviews have reported that oximetry can provide essential information about OSA when PSG is not accessible.…”

Poligrafía en niños con enfermedad neuromuscular

“…No obstante, dado el alto costo de su implementación, han sido desarrollados exámenes alternativos como la poligrafía (pG), la cual, ha mostrado tener un rendimiento diagnóstico aceptable en la población de interés [5][6][7] .…”

Paediatrics in Barcelona

“…ALONSO-ALVAREZ et al [22] studied the reliability of home respiratory polygraphy for diagnosing sleep apnoea-hypopnoea syndrome (SAHS) in 50 children with a mean age of 5.3 years. Compared with polysomnography performed in a sleep lab, when polygraphy was performed at home or in the laboratory, several SAHS indices yielded a large area under the receiver operating characteristic curve, confirming that home respiratory polygraphy is a useful technique for diagnosing SAHS in children.…”