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Comparison of nocturnal pulse oximetry with polysomnography in children with sleep disordered breathing

Catherine Jonas1,2, Surendran Thavagnanam3,4, Gregory Blecher1,2

  • 1Sleep Medicine Department, Sydney Children's Hospital, Randwick, New South Wales, Australia.

Sleep & Breathing = Schlaf & Atmung
|May 20, 2019
PubMed

Insights

Overnight oximetry is a reliable screening tool for moderate to severe obstructive sleep apnea (OSA) in children. However, a normal or mild score does not exclude OSA, necessitating polysomnography (PSG) for definitive diagnosis.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Diagnostic Accuracy

Background:

  • Polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea (OSA).
  • High costs and limited availability of PSG often lead to diagnostic delays.
  • There is a need for reliable, accessible screening tools for pediatric OSA.

Purpose of the Study:

  • To evaluate the diagnostic reliability of overnight oximetry as a screening tool for obstructive sleep apnea (OSA) in children.
  • To compare the efficacy of the McGill oximetry scoring system against PSG diagnosis.

Main Methods:

  • Retrospective study of 110 children suspected of OSA undergoing both overnight oximetry and PSG.
  • Comparison of "McGill oximetry scoring" with American Association of Sleep Medicine criteria for OSA diagnosis.

Main Results:

  • Overnight oximetry showed an overall sensitivity of 63% and specificity of 78% for OSA diagnosis.
  • McGill grades 3 and 4 oximetry scores demonstrated 100% PPV and 78% NPV for moderate/severe OSA.
  • Normal or McGill grade 2 oximetry results did not rule out OSA, with 36% and 30% of these patients having mild or moderate/severe OSA, respectively.

Conclusions:

  • Overnight oximetry is a valuable tool for screening moderate to severe pediatric OSA.
  • A normal or McGill grade 2 oximetry score does not exclude OSA.
  • Polysomnography remains essential for definitive OSA diagnosis in children.
Abstract

Keywords:
ChildrenPolysomnographyPulse oximetrySleep disordered breathing

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