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Published on: December 6, 2016
[Clinical value of portable sleep testing in children with obstructive sleep apnea syndrome]
Miaoshang Su1, Chenyi Yu1, Yuanbo Zhang1
1Department of Pediatric Respiratory Medicine, the Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325027, China.
Insights
Portable sleep testing (PAT) shows high consistency with polysomnography (PSG) for diagnosing obstructive sleep apnea syndrome (OSAS) in school-aged children. This makes PAT a reliable home-based diagnostic tool for pediatric OSAS.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Medicine
- Diagnostic Technologies
Background:
- Obstructive sleep apnea syndrome (OSAS) is a prevalent condition in children.
- Accurate diagnosis of pediatric OSAS is crucial for timely intervention and management.
- Polysomnography (PSG) is the gold standard but can be resource-intensive.
Purpose of the Study:
- To evaluate the clinical utility of the Watch-PAT (PAT) portable sleep monitor for diagnosing OSAS in children.
- To compare the diagnostic performance of PAT with PSG in a pediatric population.
- To assess the feasibility of home-based sleep testing using PAT.
Main Methods:
- A cohort of 50 snoring children aged 3-11 years underwent simultaneous PSG and PAT.
- Sleep parameters obtained from both devices were compared for consistency.
- Receiver Operating Characteristic (ROC) curve analysis was used to determine PAT's diagnostic accuracy for OSAS.
Main Results:
- PAT demonstrated high consistency with PSG in diagnosing OSAS in school-aged children (6-11 years).
- Significant differences were observed between PAT and PSG in younger children (3-5 years).
- ROC analysis indicated high sensitivity and specificity for PAT in detecting OSAS, particularly at higher Apnea-Hypopnea Index (AHI) thresholds.
Conclusions:
- The Watch-PAT device is a viable and consistent tool for diagnosing OSAS in school-aged children.
- High compliance and consistency with PSG support the use of PAT for home-based testing in this age group.
- Further validation may be needed for very young children (3-5 years).
Objective:
To determine the clinical value of portable sleep testing by Watch-PAT (PAT) in children with obstructive sleep apnea syndrome (OSAS).
Method:
Fifty cases of snoring children aged 3-11 years were randomly selected to undergo the polysomnography (PSG) and PAT simultaneously at the same night. The consistency of sleep parameters in OSAS and non - OSAS children were compared with PSG as reference standard, and ROC curve analysis was performed to assess the sensitivity and specificity in the diagnosis of OSAS with PAT portable sleep monitor.
Result:
Fourteen cases were diagnosed as OSAS in 6-11 years group by PAT and PSG. But in 3-5 years group, only six children were diagnosed as OSAS, there was significant difference between PAT and PSG (P < 0.05). Among those 6-11 years old children, compared with non-OSAS, PAT study showed that III+IV stage sleep ((30.5 ± 2.4)% vs. (38.2 ± 2.3)%, χ(2)=4.31, P<0.05), REM sleep duration ((8.9 ± 2.5)% vs. (18.3 ± 2.1)%, χ² =4.31, P<0.05), TST ((458 ± 78) min vs. (522 ± 56) min, t=4.85, P<0.05) and sleep efficiency ((83.5 ± 3.1)% vs. (93.5 ± 3.5)%, t=3.75, P<0.05) decreased, I+II stage sleep ((61.5 ± 4.4)% vs. (44.1 ± 3.5)%, χ² =6.07, P<0.05), arousal index ((29.5 ± 8.2)/h vs. (10.6 ± 5.6)/h, t=3.70, P<0.05), AHI ((7.6 ± 5.3)/h vs. (2.1 ± 2.0)/h, t=2.40, P<0.05), RDI((18.2 ± 5.1)/h vs. (6.5 ± 3.9)/h, t=3.85, P<0.05) increased in OSAS children. Furthermore, the total sleep time (TST) ((458 ± 78) min vs. (430 ± 76) min, t=2.90, P<0.05) and sleep efficiency ((83.5 ± 3.1) % vs. (81.9 ± 4.3) %, t=2.45, P<0.05) were higher by PAT than scored by PSG. ROC curve analysis showed the best threshold selection of AHI 5.0, the sensitivity was 0.952, the specificity was 0.858. AHI 7.0, the sensitivity was 0.968, the specificity was 0.985. AHI 10, the sensitivity was 0.985 and the specificity was 0.99, but AHI 1.0, the sensitivity was 0.852 and the specificity was 0.785.
Conclusion:
PAT can be used at home in school age children due to the high consistency with PSG and the high compliance.
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