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The use of pulse transit time in pediatric sleep studies: A systematic review

Laurelle A Smith1, Patrick J Dawes2, Barbara C Galland1

  • 1Department of Women's and Children's Health, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.

Sleep Medicine Reviews
|February 5, 2017
PubMed

Insights

Pulse transit time (PTT) shows promise for screening pediatric obstructive sleep apnea (OSA) when used with polysomnography. While PTT correlates with blood pressure, its clinical utility as a core diagnostic tool requires further validation.

Area of Science:

  • Cardiovascular Physiology
  • Sleep Medicine
  • Biomedical Engineering

Background:

  • Pulse transit time (PTT) is a non-invasive surrogate for blood pressure, utilized in assessing arterial function and sleep-related breathing disorders.
  • Its application in pediatric sleep studies, particularly for diagnosing conditions like obstructive sleep apnea (OSA), warrants systematic review.

Purpose of the Study:

  • To review the utility and limitations of PTT as a diagnostic tool in pediatric sleep studies.
  • To evaluate PTT's potential as a screening tool for OSA in children and adolescents.

Main Methods:

  • A systematic literature search was performed to identify studies using PTT during sleep in pediatric populations.
  • Inclusion criteria focused on studies employing PTT as a diagnostic measure in infants, children, and adolescents.
  • Twenty-one full-text articles were included, with most focusing on OSA and utilizing PTT alongside polysomnography (PSG).

Main Results:

  • PTT demonstrated potential in detecting central and obstructive apneic events in pediatric subjects, suggesting its utility as an OSA screening tool.
  • A single study showed significant negative correlations between PTT and systolic arterial pressure (SAP), with PTT tracking BP and heart rate (HR) during cardiovascular changes.
  • PTT is recognized for its simplicity, cost-effectiveness, and better tolerability compared to continuous blood pressure monitoring in children.

Conclusions:

  • PTT shows potential as a non-invasive screening tool for pediatric sleep disorders, including OSA.
  • Further research and validation are necessary to establish PTT's role as a standard clinical tool for continuous blood pressure monitoring in pediatric sleep medicine.

Keywords:
ArousalBlood pressureChildrenObstructive sleep apneaPulse transit timeSleep

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