Comparison of diagnostic reliability of out-of-center sleep tests for obstructive sleep apnea between adults and children

Suzuki, Masuko; Furukawa, Taiji; Sugimoto, Akira; Kotani, Ryosuke; Hosogaya, Rika

doi:10.1016/j.ijporl.2017.01.015

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…Previous studies have adopted different cut-off values of ODI3 for screening pediatric OSA [ 55 , 56 , 57 , 58 ]. The diversity could be caused by varied sample size and screening of the different OSA severity in each study.…”

Section: Discussionmentioning

confidence: 99%

“…The diversity could be caused by varied sample size and screening of the different OSA severity in each study. An ODI3 cut-off value of 5 events/h was reported to identify children with moderate abnormalities [ 56 ], while the cut-off value of 25 events/h was defined to diagnose severe pediatric OSA [ 58 ]. The optimal ODI3 corresponding to the polysomnography-defined severe OSA was established as ≥6.0 events/h in our discovery study and demonstrated a sensitivity of 90% and a specificity of 83%.…”

Section: Discussionmentioning

confidence: 99%

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Screening Severe Obstructive Sleep Apnea in Children with Snoring

et al. 2021

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Efficient screening for severe obstructive sleep apnea (OSA) is important for children with snoring before time-consuming standard polysomnography. This retrospective cross-sectional study aimed to compare clinical variables, home snoring sound analysis, and home sleep pulse oximetry on their predictive performance in screening severe OSA among children who habitually snored. Study 1 included 9 (23%) girls and 30 (77%) boys (median age of 9 years). Using univariate logistic regression models, 3% oxygen desaturation index (ODI3) ≥ 6.0 events/h, adenoidal-nasopharyngeal ratio (ANR) ≥ 0.78, tonsil size = 4, and snoring sound energy of 801–1000 Hz ≥ 22.0 dB significantly predicted severe OSA in descending order of odds ratio. Multivariate analysis showed that ODI3 ≥ 6.0 events/h independently predicted severe pediatric OSA. Among several predictive models, the combination of ODI3, tonsil size, and ANR more optimally screened for severe OSA with a sensitivity of 91% and a specificity of 94%. In Study 2 (27 (27%) girls and 73 (73%) boys; median age, 7 years), this model was externally validated to predict severe OSA with an accuracy of 76%. Our results suggested that home sleep pulse oximetry, combined with ANR, can screen for severe OSA more optimally than ANR and tonsil size among children with snoring.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Screening Severe Obstructive Sleep Apnea in Children with Snoring

et al. 2021

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“…Using oximetry alone has not been validated for diagnosing SDB as it will not diagnose nocturnal hypoventilation and may underestimate the severity of SDB 53 . Additionally, pulse oximetry is not recommended as the only mode of diagnosis in children due to concerns of underestimating the severity of OSA, as obstructive events can be unrelated to oxygen desaturations 54 . Despite being more reliable in diagnosing OSA in adults, it is not recommended by the adult guidelines as a diagnostic tool 32 .…”

Section: Objective Diagnostic Testing For Sdbmentioning

confidence: 99%

Sleep‐disordered breathing in cystic fibrosis

Jagpal

Jobanputra

Ahmed

et al. 2021

Pediatric Pulmonology

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Sleep‐disordered breathing (SDB) is an under recognized comorbidity in the cystic fibrosis (CF) population across the lifespan. Nocturnal hypoxemia, obstructive sleep apnea, and nocturnal hypoventilation are respiratory abnormalities that occur commonly during sleep in patients with lung disease, and have deleterious consequences to the quality of life in people with CF. Effective screening for these abnormalities is needed to allow for timely initiation of treatment, which has been reported to be efficacious. Lack of treatment leads to worsened pulmonary, cardiovascular, and metabolic outcomes in patients. In this review, we give an overview of SDB for the CF clinician, including prevalence, treatment, and suggestions for future research. We strongly encourage the CF community to incorporate evaluation for SDB in CF clinical care so that outcomes for the subset of the CF patients with comorbid SDB improve.

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“…This method has been widely validated and implemented in the adult population, and has become a realistic alternative for the diagnosis of suspected OSA in this age group [19]. However, the validation of HRP in children with suspected OSA has been less definitive, and has yet to allow for its widespread implementation in the context of the diagnosis of childhood OSA [20][21][22][23][24][25][26]. Indeed, a recent consensus from the American Academy of Sleep Medicine provided an unsupportive statement to the widespread use of HRP in children [27].…”

Section: Introductionmentioning

confidence: 99%

Validity and Cost-Effectiveness of Pediatric Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children: Rationale, Study Design, and Methodology

Oceja

Rodríguez

Jurado

et al. 2021

MPs

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Obstructive sleep apnea (OSA) in children is a prevalent, albeit largely undiagnosed disease associated with a large spectrum of morbidities. Overnight in-lab polysomnography remains the gold standard diagnostic approach, but is time-consuming, inconvenient, and expensive, and not readily available in many places. Simplified Home Respiratory Polygraphy (HRP) approaches have been proposed to reduce costs and facilitate the diagnostic process. However, evidence supporting the validity of HRP is still scarce, hampering its implementation in routine clinical use. The objectives were: Primary; to establish the diagnostic and therapeutic decision validity of a simplified HRP approach compared to PSG among children at risk of OSA. Secondary: (a) Analyze the cost-effectiveness of the HRP versus in-lab PSG in evaluation and treatment of pediatric OSA; (b) Evaluate the impact of therapeutic interventions based on HRP versus PSG findings six months after treatment using sleep and health parameters and quality of life instruments; (c) Discovery and validity of the urine biomarkers to establish the diagnosis of OSA and changes after treatment.

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Comparison of diagnostic reliability of out-of-center sleep tests for obstructive sleep apnea between adults and children

Cited by 10 publications

References 9 publications

Screening Severe Obstructive Sleep Apnea in Children with Snoring

Screening Severe Obstructive Sleep Apnea in Children with Snoring

Sleep‐disordered breathing in cystic fibrosis

Validity and Cost-Effectiveness of Pediatric Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children: Rationale, Study Design, and Methodology

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