Objectives: Although progress has been made in the standardized interpretation of nocturnal oximetry in children with obstructive sleep-disordered breathing (SDB), no evidence exists on oximetry abnormalities in other respiratory disorders. We aimed to compare obstructive lung disease (OLD) and SDB regarding nocturnal oximetry parameters. Methods:We analyzed oximetry recordings from children with (i) OLD (obliterative bronchiolitis; cystic fibrosis); (ii) snoring and adenotonsillar hypertrophy (SDB); and (iii) no respiratory disorder (controls). The three groups were compared regarding:(i) oxygen desaturation of hemoglobin index (SpO 2 drops ≥3%/h-ODI3) and (ii) basal SpO 2 (average SpO 2 between SpO 2 drops). The associations of oximetry parameters (natural logarithm) with study group were tested using linear regression including age as covariate.Results: Data of 16 subjects with OLD (median age: 7.3 years; Q25, Q75: 5.4, 12), 22 children with SDB (6.3 years; 4, 9) and 22 controls (6.8 years; 5.6, 10.3) were analyzed.Children with OLD or SDB had significantly lower basal SpO 2 than controls (91.9% [90.8, 93.4] vs 96.3% [96, 97.4] vs 97.6% [97.1, 97.9]; P < 0.01). No subjects in the SDB or control groups had basal SpO 2 < 95%. Children with SDB had significantly higher ODI3 than children with OLD or controls [8.4 episodes/h (6.2, 16.6) vs 4.4 episodes/h(3.6, 6.6) vs 2 episodes/h (1.3, 2.7); P < 0.01]. OLD had the greatest negative effect on basal SpO 2 (R 2 = 0.62; P < 0.001) and SDB the greatest positive effect on ODI3 (R 2 = 0.34; P < 0.001).Conclusion: OLD is associated mostly with reduced basal SpO 2 , whereas SDB is characterized by elevated ODI3. K E Y W O R D S adenotonsillar hypertrophy, cystic fibrosis, obliterative bronchiolitis, obstructive sleep apnea, sleep hypopnea
ObjectivesEvidence for nocturnal oximetry interpretation in patients with abnormal neuromuscular function is limited. We aimed to compare children with neuromuscular disease (NMD) or Prader‐Willi syndrome (PWS) to otherwise healthy subjects with obstructive sleep‐disordered breathing (SDB) or without respiratory disorder (controls) regarding nocturnal oximetry parameters.MethodsWe analyzed recordings from children with: (a) NMD; (b) PWS; (c) snoring and adenotonsillar hypertrophy and/or obesity (SDB); and (d) controls. Outcomes included: (a) basal SpO2; (b) proportions of subjects with McGill oximetry score (MOS) >1 (clusters of desaturations); and (c) desaturation index (SpO2 drops ≥3%/h‐ODI3).ResultsData of 12 subjects with NMD (median age, 5.2 years; IQR, 2.7, 8.2), 14 children with PWS (5 years; 2.3, 6.9), 21 children with SDB (5.8 years; 4.6, 9.6), and 20 controls (6.2 years; 5.4, 11.2) were analyzed. Children with NMD, PWS, and SDB had lower basal SpO2 than controls (95.6% [94.5%, 96.9%], 96.2% [95.1%, 97.4%], 96.1% [95.8%, 97.5%] vs 97.8% [97.2%, 97.9%], respectively; (P < .01). NMD and PWS showed the greatest negative effect on basal SpO2 (P < .05). Children with SDB or PWS had a higher risk of MOS >1 than patients with NMD (OR, 25.9 [95% CI, 3.4‐200.4] and 9.5 [1.5‐62.6]). NMD, PWS, and SDB were similar regarding ODI3, which was elevated compared to ODI3 in controls (P < .05). Frequent desaturations predominated in NMD, while periods of sustained desaturation were noted in NMD and PWS.ConclusionPWS and NMD have a negative effect on basal SpO2, while clusters of desaturations are prevalent in patients with PWS or obstructive SDB.
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