Nocturnal oximetry in children with obstructive lung disease or sleep‐disordered breathing

Abstract

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

Sleep Studies for Clinical Indications during the First Year of Life: Infants Are Not Small Children

“…Given the difficulties in performing and interpreting PSG during the first year of life, nocturnal oximetry has been increasingly popular for the diagnosis and management of OSAS especially in settings with limited resources [34]. It is readily available in most medical facilities across the globe, far less time is required for its interpretation relative to PSG and polygraphy, characteristic desaturation patterns have been described corresponding to upper airway obstruction or obstructive lung disease, and intermittent hypoxemia is associated with known adverse alterations in multiple organ systems [35][36][37].…”

Nocturnal oximetry parameters as predictors of sleep apnea severity in resource‐limited settings

“…Given the cost and limited availability of paediatric PSG, alternative diagnostic modalities like nocturnal pulse oximetry or validated questionnaires have been applied in both in‐ and outpatient settings around the globe (Garde et al, 2019; Hornero et al, 2017; Kaditis, Kheirandish‐Gozal, & Gozal, 2016; Katsouli et al, 2019; Papadakis et al, 2018; Villa et al, 2015). The diagnostic value of nocturnal oximetry is based on the frequent association of upper airway obstructive events with intermittent hypoxaemia (abrupt SpO 2 drops) (Goh et al, 2000).…”

Sleep in children with cystic fibrosis: More under the covers

“…Since the first publication on sleep in children with cystic fibrosis in 1983 21 there have been multiple additional studies and reports (see a recent review in this journal). 22 Thirteen pediatric studies explored PSG findings, 21,[23][24][25][26][27][28][29][30][31][32][33][34] three utilized nocturnal oximetry, [35][36][37] and one reported the results of nocturnal noninvasive ventilation. 38 One study assessed ENT examination and endoscopy findings, 39 another nocturnal cough, 40 and one transcutaneous blood gas levels.…”