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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

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Diagnosis of obstructive sleep apnea in children: a systematic review

Pablo E Brockmann1, Christine Schaefer, Anette Poets

  • 1Working Group on Pediatric Sleep Medicine, Department of Neonatology, University Children's Hospital Tuebingen, Calwer Str. 7, 72076 Tuebingen, Germany.

Sleep Medicine Reviews
|February 5, 2013
PubMed

Insights

Diagnostic tests for childhood obstructive sleep apnea (OSA) show promise. Sleep lab polygraphy, urinary biomarkers, and rhinomanometry demonstrated excellent diagnostic test accuracy (DTA) compared to polysomnography (PSG).

Area of Science:

  • Pediatric Sleep Medicine
  • Diagnostic Accuracy Research
  • Respiratory Medicine

Background:

  • Obstructive sleep apnea (OSA) is a common condition in children.
  • Polysomnography (PSG) is the gold standard for diagnosing OSA, but it is resource-intensive.
  • Accurate and accessible diagnostic alternatives are needed for pediatric OSA screening.

Purpose of the Study:

  • To systematically review the diagnostic test accuracy (DTA) of various tests for identifying OSA in children.
  • To compare the DTA of alternative diagnostic methods against PSG.

Main Methods:

  • A systematic review was conducted following Cochrane Collaboration DTA criteria.
  • Studies comparing any diagnostic test for OSA with PSG in children were included.
  • Study quality was assessed, and DTA measures were recalculated; excellent DTA was defined as positive likelihood ratio (PLR) > 10 and negative likelihood ratio (NLR) < 0.1.

Main Results:

  • 33 studies met inclusion criteria from 1064 initially identified; overall study quality was low.
  • 40 different tests were compared to PSG, with only 13 studies using the accepted OSA definition (apnea-hypopnea index ≥1).
  • Sleep lab-based polygraphy, urinary biomarkers, and rhinomanometry demonstrated excellent DTA (high PLR, low NLR) in select studies.

Conclusions:

  • Evidence for alternative diagnostic tests for pediatric OSA is limited but growing.
  • Polygraphy, urinary biomarkers, and rhinomanometry show potential as valid diagnostic tools for OSA in children.
  • Further research is required to confirm the high DTA of these promising alternative tests.
Abstract

Keywords:
PediatricPolysomnographySleep disordered breathingSnoring

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