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Can overnight portable pulse oximetry be used to stratify obstructive sleep apnea risk in infants? A correlation

Zarmina Ehsan1,2, Shan He3, Guixia Huang4,5

  • 1Division of Pulmonary and Sleep Medicine, Children's Mercy-Kansas City, Kansas City, Missouri.

Pediatric Pulmonology
|June 6, 2020
PubMed

Insights

Overnight oximetry shows a significant correlation with polysomnography for infant obstructive sleep apnea (OSA). An oxygen desaturation index (ODI40) greater than 3 can help identify infants needing further evaluation for moderate to severe OSA.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Diagnostic Accuracy Studies

Background:

  • Limited evidence exists on using oximetry to evaluate infant obstructive sleep apnea (OSA).
  • Overnight oximetry is a potential tool for stratifying infants at risk for OSA.
  • Determining the urgency for polysomnography (PSG) is crucial for timely intervention.

Purpose of the Study:

  • To assess the utility of overnight oximetry in stratifying infants for OSA risk.
  • To correlate oximetry-derived metrics with polysomnography findings.
  • To determine if oximetry can guide the need for definitive PSG screening.

Main Methods:

  • Retrospective cohort study of 38 infants undergoing both PSG and overnight oximetry.
  • Correlated oxygen desaturation index (ODI40 and ODI410) with the apnea-hypopnea index (AHIo).
  • Analyzed data from both in-hospital (attended) and at-home (unattended) oximetry settings.

Main Results:

  • A statistically significant positive correlation was found between ODI and AHIo (ODI40 vs. AHIo [r = .59, P < .001]).
  • An ODI40 cutoff of 3 demonstrated high sensitivity (86%) and positive predictive value (80%) for OSA (AHIo > 2).
  • For moderate to severe OSA (AHIo ≥ 5), an ODI40 cutoff of 3 showed 100% sensitivity and 100% negative predictive value.

Conclusions:

  • Overnight oximetry, specifically ODI40, significantly correlates with PSG findings in infants at risk for OSA.
  • An ODI40 threshold greater than 3 appears useful for risk stratification of moderate to severe OSA.
  • Oximetry can be employed in both attended and unattended settings to aid in OSA evaluation.
Abstract

Keywords:
infantobstructive sleep apneaoximetry

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