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Validation of the MediByte Portable Monitor for the Diagnosis of Sleep Apnea in Pediatric Patients
Ahmed I Masoud1, Pallavi P Patwari2,3, Pranshu A Adavadkar2
1Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Insights
Portable sleep monitors (PMs) accurately diagnose moderate to severe sleep apnea in children, correlating well with polysomnography (PSG). This offers a valuable alternative, especially for older pediatric patients, reducing diagnostic delays.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
- Diagnostic Technology Evaluation
Background:
- Polysomnography (PSG) is the gold standard for diagnosing sleep apnea but has limited availability for pediatric patients.
- Limited access to PSG can cause diagnostic delays, potentially worsening associated comorbidities in children.
- Portable monitors (PMs) offer a potential solution to improve access to sleep apnea diagnosis in pediatric populations.
Purpose of the Study:
- To evaluate the diagnostic accuracy of a portable sleep monitor (MediByte) compared to laboratory-based PSG.
- To assess the correlation of apnea-hypopnea index (AHI) and oxygen saturation measurements between PM and PSG.
- To determine the utility of PMs in diagnosing sleep apnea in pediatric patients.
Main Methods:
- A consecutive series of pediatric patients underwent simultaneous PSG and MediByte PM monitoring.
- Apnea-hypopnea index (AHI) was calculated for both PSG and PM (manual and auto-scoring).
- Pearson correlation and Bland-Altman plots were used to compare AHI and oxygen saturation data.
Main Results:
- PM-derived AHI (manual and auto-scored) showed strong correlation with PSG-derived AHI (r ≥ .932, P < .001).
- Oxygen saturation correlation between PM and PSG was significant in older children (12-17 years) but not younger ones (7-11 years).
- PM demonstrated high sensitivity and specificity (>93%) for detecting severe sleep apnea (AHI ≥ 10 events/h).
Conclusions:
- Portable monitors (PMs) demonstrate high accuracy in diagnosing moderate to severe pediatric sleep apnea.
- PMs can be a valuable tool to aid in the diagnosis of sleep apnea, particularly in older children.
- While PSG remains recommended, PMs can help mitigate diagnostic delays and improve management of pediatric sleep apnea.
Study Objectives:
Polysomnography (PSG) is considered the gold standard in the diagnosis of sleep apnea. In pediatric patients, because of limited availability and access to laboratory-based PSG, there can be significant delays in the diagnosis and management of sleep apnea that can result in progressive associated comorbidities. The main objective of the current study was to test the diagnostic value of a portable sleep monitor (PM), the MediByte, in comparison with laboratory PSG in pediatric patients wearing both setups simultaneously.
Methods:
A consecutive series of pediatric patients referred to the University of Illinois Sleep Science Center wore the MediByte during simultaneous PSG. The apnea-hypopnea index (AHI) was calculated for PSG and both manual and autoscoring functions of the PM. Pearson correlation and Bland-Altman plots were assessed.
Results:
A total of 70 patients successfully completed simultaneous PSG and PM studies (median age 10.8 years). The AHI obtained both manually and automatically scored PM studies strongly correlated with the AHI obtained from the PSG (r ≥ .932, P < .001). The oxygen saturation obtained by the PM showed significant correlation with that obtained by PSG among children aged 12 to 17 years (P < .001), but not among children aged 7 to 11 years (P ≥ .24). The sensitivity and specificity for detection of severe sleep apnea diagnosed by PSG (AHI ≥ 10 events/h) using both PM scoring methods was very high (> 93% for both).
Conclusions:
Although PSG is still recommended for the diagnosis of sleep apnea, PMs can play a valuable role in diagnosing moderate and severe sleep apnea, especially in older pediatric patients.
Commentary:
A commentary on this article appears in this issue on page 685.
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