Is oximetry an effective screening tool for obstructive sleep apnoea in children with Down syndrome?

Overnight Pulse Oximetry for Evaluation of Sleep Apnea among Children with Trisomy 21

“…We did not use detailed follow-up to evaluate the sensitivity of the McGill oximetry score in this population, 14 but we contend that with, a few caveats, oximetry scores will prove useful in the identifi cation of the highest risk patients for early evaluation and possible treatment, particularly within clinical research protocols.…”

Obstructive Sleep Apnea in Individuals with Down Syndrome: A Meta-Analytic Literature Review

“…However, since PSG was the reference standard to accurately diagnose OSA, 13 studies were excluded due to their use of parental questionnaire [14]- [26] or endoscope [27]- [29]; three studies were excluded due to their use of pulse oximetry, a less accurate indicator of OSA [9], [30], [31] and/or in-home sleep studies [11]; 24 studies were eliminated because only partial or incomplete information was provided [2], [32]- [40], [27], [41]- [53]; three were excluded due to imaging of the airway…”

“…In a study examining 56 children with DS, the positive predictive value for parental-based diagnoses of OSA was 36.4% (4/11), while the negative predictive value was 45.8% (11/24) [4]. In addition, while the use of in-home sleep studies and overnight pulse oximetry has been rising, especially when there is a lack of or inability to conduct PSG, their accuracy in diagnosing OSA remains questionable [9]. In a review assessing the accuracy of oximetry in 25 published studies involving normal children, oximetry use accurately identified those individuals with moderate to severe OSA [10].…”

American Academy of Sleep Medicine Position Paper for the Use of a Home Sleep Apnea Test for the Diagnosis of OSA in Children

“…HSATs have been used in a few other small studies of children with comorbid conditions, but the validity and feasibility of the tests were not the focus of those reports. [25][26][27][28] Finally, our review of the literature identified no validation studies for the use of HSATs in infants and young children (< 2 years old). These populations present unique challenges to diagnostic testing, and the consequences of misdiagnosing or underdiagnosing are potentially more severe.…”