Role of overnight oximetry in assessing the severity of obstructive sleep apnoea in typically developing children: a multicentre study.

Autor:	Selby A; Faculty of Medicine, University of Southampton, Southampton, UK a.c.selby@soton.ac.uk.; Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Buchan E; Respiratory and Sleep Physiology, Royal Hospital for Children, Glasgow, UK., Davies M; Respiratory Sleep Unit, Great Ormond Street Hospital for Children, London, UK., Hill CM; Faculty of Medicine, University of Southampton, Southampton, UK.; Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Kingshott RN; Department of Respiratory Medicine, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK., Langley RJ; Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children, Glasgow, UK., McGovern J; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK., Presslie C; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK., Senior E; Paediatric Sleep and Respiratory Medicine Department, Guy's and St Thomas' Hospitals NHS Trust, London, UK., Shinde SS; Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK., Yuen HM; Faculty of Medicine, University of Southampton, Southampton, UK., Samuels M; Paediatric Respiratory and Sleep Medicine, Great Ormond Street Hospital for Children, London, UK., Evans HJ; Child Health, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood [Arch Dis Child] 2024 Mar 19; Vol. 109 (4), pp. 308-313. Date of Electronic Publication: 2024 Mar 19.
DOI:	10.1136/archdischild-2023-326191
Abstrakt:	Background and Objective: Cardiorespiratory polygraphy (CRP) is the predominant technology used to diagnose obstructive sleep apnoea (OSA) in tertiary centres in the UK. Nocturnal pulse oximetry (NPO) is, however, cheaper and more accessible. This study evaluated the ability of NPO indices to predict OSA in typically developing (TD) children. Methods: Indices from simultaneous NPO and CRP recordings were compared in TD children (aged 1-16 years) referred to evaluate OSA in three tertiary centres. OSA was defined as an obstructive apnoea-hypopnoea index (OAHI) ≥1 event/hour. Receiver operating characteristic curves assessed the diagnostic accuracy of NPO indices including ODI3 (3% Oxygen Desaturation Index, ODI4 (4% Oxygen Desaturation Index), delta 12 s index and minimum oxygen saturation. Two-by-two tables were generated to determine the sensitivities and specificities of whole number cut-off values for predicting OAHIs ≥1, 5 and 10 events/hour. Results: Recordings from 322 TD children, 197 male (61.2%), median age 4.9 years (range 1.1-15.6), were reviewed. OAHI was ≥1/hour in 144 (44.7%), ≥5/hour in 61 (18.9%) and ≥10/hour in 28 (8.7%) cases. ODI3 and ODI4 had the best diagnostic accuracy. ODI3 ≥7/hour and ODI4 ≥4/hour predicted OSA in TD children with sensitivities/specificities of 57.6%/85.4% and 46.2%/91.6%, respectively. ODI3 ≥8/hour was the best predictor of OAHI ≥5/hour (sensitivity 82.0%, specificity 84.3%). Conclusion: Raised ODI3 and ODI4 predict OSA in TD children with high specificity but variable sensitivity. NPO may be an alternative to diagnose moderate-severe OSA if access to CRP is limited. Low sensitivities to detect mild OSA mean that confirmatory CRP is needed if NPO is normal. Competing Interests: Competing interests: All authors have completed the ICMJE disclosure form at http://www.icmje.org/disclosure-of-interest/ and declare no financial support from any organisations for the submitted work. In the past 3 years, AS has received research grants from the Asthma, Allergy and Inflammation and Research (AAIR) charity and NIHR; CMH has received a research grant from the NIHR, an educational grant from Flynn Pharma, payment for advisory work for Neurim Pharmaceuticals and has undertaken advisory work for Public Health England; RJL has received grants from the Glasgow Children’s Hospital and Innovate UK and speaker fees from Sleep Consultancy. Other authors have no competing interests to declare. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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