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Agreement between manual and automatic analyses of home sleep examinations in pediatric obstructive sleep apnea

Marie Ørntoft1, Ida G Andersen1, Preben Homøe1,2

  • 1Department of Otorhinolaryngology & Maxillofacial Surgery, Zealand University Hospital, 4600 Køge, Denmark.

Journal of Comparative Effectiveness Research
|May 25, 2019
PubMed

Insights

Manual and automatic analyses of home sleep apnea tests in children show poor agreement. Automatic analysis consistently overestimates the apnea-hypopnea index (AHI), impacting pediatric sleep apnea diagnostics.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Physiology

Background:

  • Home sleep testing (HST) is increasingly utilized for diagnosing pediatric obstructive sleep apnea (OSA).
  • Accurate analysis of HST data is crucial for effective OSA management in children and adolescents.

Purpose of the Study:

  • To evaluate the concordance between manual and automated scoring of HST data in a pediatric population.
  • To identify potential discrepancies in the apnea-hypopnea index (AHI) calculation between two analytical methods.

Main Methods:

  • Utilized type 3 sleep monitoring devices (Nox T3) for home sleep recordings.
  • Performed dual analysis: manual scoring by a certified polysomnographic technologist and automatic scoring using Noxturnal software (version 5.1).
  • Included 51 sleep studies from children and adolescents (median age 13.6 years).

Main Results:

  • A significant difference was observed in the median apnea-hypopnea index (AHI) between manual (2.7) and automatic (11.9) analyses (p < 0.001).
  • The study revealed a poor agreement between manual and automatic scoring methods.
  • Automatic analysis demonstrated a consistent overestimation of the AHI compared to manual scoring.

Conclusions:

  • The current automatic analysis software may not reliably replicate manual scoring for pediatric HST.
  • Overestimation of AHI by automatic analysis could lead to misdiagnosis or inappropriate treatment decisions in pediatric OSA.
  • Further refinement of automatic scoring algorithms is warranted to improve accuracy in pediatric sleep studies.

Keywords:
Noxturnalautomatic analysishome sleep examinationpediatric obstructive sleep apneaportable monitoring

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