Study design considerations for sleep-disordered breathing devices

Mann, Eric A.; Nandkumar, S.; Addy, Nancy; Demko, B. Gail; Freedman, Neil; Gillespie, M. Boyd; Headapohl, W; Kirsch, Douglas B.; Phillips, Barbara; Rosen, Ilene M.; Schneider, Logan; Stepnowsky, Carl; Yaremchuk, Kathleen; Eydelman, Malvina B.

doi:10.5664/jcsm.8226

Cited by 13 publications

(6 citation statements)

References 39 publications

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“…Third, there are no universally agreed upon AHI and RDI values for diagnosing or grading the severity of OSA in pediatric patients due to the significant anatomic heterogeneity exhibited across age groups [12,16]. Lastly, the results obtained from PSG have been demonstrated to lack consistency across sessions potentially limiting the quality of our data [23][24][25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a Pediatric Sleep Questionnaire for the Diagnosis of Obstructive Sleep Apnea in Children

Ferry¹,

Wright²,

Ohlstein³

et al. 2020

Cureus

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Background: Obstructive sleep apnea (OSA) is a source of significant morbidity in children. Polysomnography (PSG), the gold standard diagnostic tool for OSA, is often unavailable due to patient financial and geographic constraints. Our objective is to analyze the relationship between a patient's subjective complaints and the results from their PSG to determine the diagnostic value of the Pediatric Sleep Questionnaire (PSQ) for detecting OSA in children.Methods: A retrospective chart review was conducted for pediatric patients with suspected OSA from March 2012 to January 2014. Preoperative PSQ scores were compared with the results from PSG in the form of Apnea-Hypopnea Index (AHI) and Respiratory Disturbance Index (RDI) values. AHI and RDI values ranging from 1 to 5 were classified as mild OSA while values ranging from 5 to 10 were classified as moderate OSA.Results: A total of 161 patients were recruited for this study with 63 patients (39%) both completing the PSQ and undergoing PSG. Sensitivity of the positive questionnaire was higher in patients with AHI and RDI values indicative of moderate OSA (95% and 100% respectively) versus values indicative of mild OSA (83% and 86% respectively). Conversely, the positive predictive value of the positive questionnaire (n=49) was lower in patients with AHI and RDI values indicative of moderate OSA (39% and 46% respectively) versus values indicative of mild OSA (70% and 80% respectively). Conclusion:The PSQ has high diagnostic value for screening patients with suspected OSA. We recommend the use of the PSQ in the primary care setting for children with suspected OSA.

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Section: Discussionmentioning

confidence: 99%

Efficacy of a Pediatric Sleep Questionnaire for the Diagnosis of Obstructive Sleep Apnea in Children

Ferry¹,

Wright²,

Ohlstein³

et al. 2020

Cureus

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“…Other expert panels have recognized this problem and recommended against the inclusion of arousals in scoring until greater interscorer reliability has been achieved. 13 More importantly, the position paper cited only two studies to support the contention that arousal-based scoring identifies patients who benefit from treatment. Both were observational, neither had a control group, and combined they included only 50 patients.…”

Section: Arousals Vs Desaturation Criterion For Hypopneas: Association With Outcomes and Response To Treatmentmentioning

confidence: 99%

POINT: Should Hypopneas Only Be Scored When Accompanied By Oxygen Desaturation? Yes

Holley

Phillips

2021

Chest

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“…The current gold standard is a laboratory polysomnography (PSG) system which includes: respiratory effort, oronasal airflow, and pulse oximetry to monitor respiration, brain, cardiac, and eye activity to assess sleep stages and arousals, plus other sensors for muscular activity and body movements. Other systems, such as home sleep apnea tests (HSATs), can simplify multiple nights of recordings by measuring sleep at home and reduce the psychological lab effect, but compromise the number of signals available, depending on the HSAT class (Ferber et al 1994, Mann et al 2020.…”

Section: Introductionmentioning

confidence: 99%

Quantitative validation of the suprasternal pressure signal to assess respiratory effort during sleep

Cerina,

Papini,

Fonseca

et al. 2024

Physiol. Meas.

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Objective Intra-esophageal pressure (Pes) measurement is the recommended goldstandard to quantify respiratory effort during sleep, but used to limited extentin clinical practice due to multiple practical drawbacks. Respiratory inductanceplethysmography belts (RIP) in conjunction with oronasal airflow are the acceptedsubstitute in polysomnographic systems (PSG) thanks to a better usability, althoughthey are partial views on tidal volume and flow rather than true respiratory effort andare often used without calibration. In their place, the pressure variations measurednon-invasively at the suprasternal notch (SSP) may provide a better measure ofeffort. However, this type of sensor has been validated only for respiratory eventsin the context of obstructive sleep apnea syndrome (OSA). We aim to provide anextensive verification of the suprasternal pressure signal against RIP belts and Pes,covering both normal breathing and respiratory events. Approach We simultaneouslyacquired suprasternal (207) and esophageal pressure (20) signals along with RIP beltsduring a clinical PSG of 207 participants. In each signal, we detected breaths with acustom algorithm, and evaluated the SSP in terms of detection quality, breathing rateestimation, and similarity of breathing patterns against RIP and Pes. Additionally,we examined how the SSP signal may diverge from RIP and Pes in presence ofrespiratory events scored by a sleep technician. Main results The SSP signal proved tobe a reliable substitute for both esophageal pressure (Pes) and respiratory inductanceplethysmography (RIP) in terms of breath detection, with sensitivity and positivepredictive value exceeding 75 %, and low error in breathing rate estimation. TheSSP was also consistent with Pes (correlation of 0.72, similarity 80.8 %) in patternsof increasing pressure amplitude that are common in OSA. Significance This workprovides a quantitative analysis of suprasternal pressure sensors for respiratory effortmeasurements.

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Study design considerations for sleep-disordered breathing devices

Cited by 13 publications

References 39 publications

Efficacy of a Pediatric Sleep Questionnaire for the Diagnosis of Obstructive Sleep Apnea in Children

Efficacy of a Pediatric Sleep Questionnaire for the Diagnosis of Obstructive Sleep Apnea in Children

POINT: Should Hypopneas Only Be Scored When Accompanied By Oxygen Desaturation? Yes

Quantitative validation of the suprasternal pressure signal to assess respiratory effort during sleep

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