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Published on: January 26, 2019
Polysomnographic Oxygen Saturation Findings for Preteen Children versus Adolescents
Nathan D Wiebracht1, Shan He2,3, Colin Cotton2
11 Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
Insights
Home oximetry is a common screening tool for obstructive sleep apnea (OSA) in children. This study found that oxygen saturation levels and desaturation indices do not significantly differ between preteen and adolescent children with OSA.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
- Diagnostic Screening
Background:
- Home oximetry is frequently used for obstructive sleep apnea (OSA) screening in pediatric populations.
- Established normal oxygen desaturation levels by disease severity are lacking for children.
- Understanding age-related differences in oxygen saturation is crucial for accurate OSA diagnosis.
Purpose of the Study:
- To determine if oxygen saturation levels vary by obstructive sleep apnea (OSA) severity in children.
- To compare these oxygen saturation differences between preteen and adolescent age groups.
- To evaluate the utility of home oximetry across different pediatric age brackets for OSA screening.
Main Methods:
- Retrospective case series of 342 children aged 6-18 years undergoing polysomnography.
- Statistical analysis included Chi-square, Wilcoxon rank sum, and Kruskal-Wallis tests.
- Comparison of oxygen saturation indices and apnea-hypopnea index between preteen (6-12) and adolescent (13-18) groups.
Main Results:
- Adolescents exhibited longer sleep times and a higher mean obstructive apnea-hypopnea index compared to preteens.
- Oxygen saturation levels and 3%/4% oxygen desaturation indices showed no significant differences between age groups when adjusted for OSA severity.
- The distribution of OSA severity was 50% no OSA, 32% mild, 10% moderate, and 8% severe.
Conclusions:
- While adolescents have more severe OSA indicators like longer sleep times and higher apnea-hypopnea index, their oxygen saturation patterns are similar to preteens.
- These findings support the current triage algorithms for pediatric OSA, indicating no significant age-based disparities in oxygen desaturation.
- Home oximetry appears to be a consistent screening tool across preteen and adolescent populations for obstructive sleep apnea.
Abstract:
Objective Home oximetry is commonly used to screen for obstructive sleep apnea (OSA) in children; however, normal oxygen desaturation levels by disease severity are not well known. It was our objective to determine if oxygen saturation levels differed by OSA severity category in children and if these differences were similar for preteen children and adolescents. Study Design Retrospective case series of children undergoing polysomnography from September 2011 to July 2015. Setting Tertiary pediatric hospital. Subjects and Methods Six- to 18-year-olds (preteen, 6-12 years old; adolescent, 13-18 years old). Chi-square, Wilcoxon rank sum test, and Kruskal-Wallis testing were used to compare variables between age groups. Results The study included 342 children with a mean age of 11.3 ± 2.4 years (range, 6.5-17.5) and a mean body mass index of 25.6 ± 9.2 kg/m2 (78 ± 29 percentile); 61% were white, 35% were black, and 4% were other or unknown. Of the children, 48% were female, and this was not a significant difference between age groups ( P = .81). Overall, 50% of the children had no OSA, 32% mild, 10% moderate, and 8% severe. When compared with the younger children, the adolescents had a longer sleep time ( P = .014) and a higher mean obstructive apnea-hypopnea index (3.53 ± 5.1 vs 3.03 ± 6.1 events per hour, P = .02). The 3% and 4% oxygen desaturation indices were not significantly different between age groups when accounting for OSA severity. Conclusion Adolescents have longer sleep times and higher obstructive apnea-hypopnea indexes than preteens, but oxygen saturations and desaturation indices were similar. This supports current triage algorithms for children with OSA, as we found no significant age-based differences.
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