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Can standard deviation of overnight pulse oximetry be used to screen childhood obstructive sleep apnea

Siriporn Warapongmanupong1, Aroonwan Preutthipan1

  • 1Division of Pediatric Pulmonology, Department of Pediatrics, and Ramathibodi Hospital Sleep Disorder Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

International Journal of Pediatric Otorhinolaryngology
|January 22, 2019
PubMed

Insights

The standard deviation of oxygen saturation (SpO2) during overnight monitoring is a reliable indicator for diagnosing moderate to severe obstructive sleep apnea (OSA) in children. This simple measurement can confidently predict OSA, aiding in initial investigations.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Diagnostic Accuracy

Background:

  • Pulse oximetry (PO) is often used as a substitute for polysomnography (PSG) in pediatric evaluations.
  • Identifying the most effective statistical parameters from PO monitoring is crucial for accurate diagnosis.

Purpose of the Study:

  • To determine the most suitable statistical parameters from overnight PO monitoring for diagnosing childhood obstructive sleep apnea (OSA).
  • To evaluate the diagnostic performance of these parameters compared to PSG.

Main Methods:

  • Prospective recruitment of children with snoring for simultaneous PO monitoring and PSG.
  • Analysis of eight statistical SpO2 parameters to identify the best diagnostic performance using receiver-operating characteristic curves (AUC).
  • Validation of the standard deviation (SD) of SpO2 in a larger retrospective cohort.

Main Results:

  • The standard deviation (SD) of SpO2 demonstrated the largest AUC in identifying suitable parameters.
  • SD of SpO2 showed a strong correlation with the apnea/hypopnea index (AHI) (r=0.6, P<0.001).
  • For moderate to severe OSA (AHI ≥5), the AUC was 0.74. An SD ≥1.06 achieved 97% specificity and 92% positive predictive value.

Conclusions:

  • Calculating the SD of SpO2 is a practical and valuable initial investigation for childhood OSA.
  • An SD of SpO2 ≥1.06 reliably predicts moderate to severe OSA in children.
  • This method offers a simple, accessible, and confident approach to OSA screening.
Abstract

Keywords:
AdenotonsillectomyChildrenObstructive sleep apneaPolysomnographyScreening test

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