Nocturnal Pulse Oximetry Is Better than Snoring Sound Analysis for Screening Severe Pediatric Obstructive Sleep Apnea
| Autor: | Hsueh-Yu Li, Hai-Hua Chuang, Chung-Guei Huang, Chung-Jan Kang, Jen-Fu Hsu, Li Ang Lee, Yu-Shu Huang, Cheryl C.H. Yang, Ning-Hung Chen, Ming-Ying Zhuo, Hui-Shan Hsieh, Li-Pang Chuang, Gui-She Lee, Terry B. J. Kuo |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry musculoskeletal neural and ocular physiology Area under the curve Polysomnography Odds ratio medicine.disease Logistic regression nervous system diseases respiratory tract diseases Obstructive sleep apnea Pulse oximetry Internal medicine medicine Breathing Cardiology Loud snoring business |
| DOI: | 10.22541/au.160157548.82572588 |
| Popis: | Introduction: Efficacious screening of severe obstructive sleep apnea (OSA) is important for children with sleep-disordered breathing before time-consuming nocturnal polysomnography. However, the predictive performance of clinical variables, nocturnal unattended pulse oximetry, and snoring sound analysis to screen for severe pediatric OSA has not been comprehensively investigated. Methods: Forty-two consecutive children (11 [26%] girls and 31 [74%] boys; median age, 9 years; median body-mass index of 19.0 kg/m2) with loud snoring were prospectively recruited to undergo standard polysomnography, nocturnal pulse oximetry, and snoring sound analysis. Results: Binary logistic regression models showed that oxygen desaturation index ≥ 3% (> 5.9 events/h), adenoidal‐nasopharyngeal ratio (> 0.782), snoring sound energy of 801-1000 Hz (> 22.1 dB), and tonsil size (> 3) significantly predicted severe OSA, in descending order of odds ratio. Multivariate analysis showed that oxygen desaturation index ≥ 3%, adenoidal‐nasopharyngeal ratio, and tonsil size independently predicted severe OSA, and that their combination best predicted severe OSA (sensitivity = 91%; specificity = 84%; area under the curve = 0.92; p < 0.001). Conclusions: Our results suggested that pulse oximetry is better than snoring sound analysis to screen for severe OSA in children with loud snoring. A combination of oxygen desaturation index ≥ 3%, adenoidal‐nasopharyngeal ratio, and tonsil size can be used to efficiently screen for severe pediatric OSA. |
| Databáze: | OpenAIRE |
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