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Improving detection of obstructive sleep apnoea by overnight oximetry in children using pulse rate parameters

Dg Zuraini Sahadan1, Margot J Davey2,3, Rosemary S C Horne3

  • 1Paediatric Respiratory Unit, Serdang Hospital, Selangor Darul Ehsan, Malaysia.

Sleep & Breathing = Schlaf & Atmung
|March 6, 2015
PubMed

Insights

Pulse rate indices (PRI) from overnight oximetry show promise for diagnosing obstructive sleep apnoea (OSA) in children. A PRI-15 threshold of >35/h demonstrated high specificity for identifying OSA in children with inconclusive oximetry results.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Diagnostic Tools

Background:

  • Overnight oximetry is a common diagnostic tool for obstructive sleep apnoea (OSA) in children.
  • However, it often yields inconclusive results for children with obstructive events causing arousal but not desaturation.
  • This limitation necessitates improved diagnostic methods for pediatric OSA.

Purpose of the Study:

  • To investigate the utility of pulse rate indices (PRI) and pulse rate standard deviation (PR-SD) derived from overnight oximetry in diagnosing pediatric OSA.
  • To determine if these pulse rate parameters can enhance the diagnostic accuracy of oximetry in children with suspected OSA.

Main Methods:

  • Children with suspected OSA underwent home overnight oximetry and, if results were normal, polysomnography (PSG).
  • Oximetry data, including PR-SD and PRI (rises of 8, 10, and 15 beats/min per hour), were analyzed using commercial software.
  • Pulse rate parameters were compared between children diagnosed with OSA (obstructive apnoea-hypopnoea index >1 event/h) and those without OSA.

Main Results:

  • Of 93 children with normal oximetry who underwent PSG, 57 (61%) had OSA.
  • PR-SD did not differ significantly between OSA and non-OSA groups (p=0.87).
  • PRI values tended to be higher in the OSA group, with PRI-15 showing a significant difference (p=0.04) and a threshold of >35/h achieving 97% specificity for OSA.

Conclusions:

  • The PRI-15 metric derived from overnight oximetry shows potential as a valuable indicator for diagnosing OSA in children.
  • This finding suggests that incorporating PRI analysis could improve the diagnostic yield of oximetry in pediatric OSA evaluations.
  • Further research may validate PRI-15 as a standalone or adjunctive diagnostic marker for pediatric OSA.
Abstract

Keywords:
ChildObstructive sleep apnoeaOximetryPulse rate

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