Related Experiment Video
Updated: Dec 9, 2025
Method to Obtain Pattern of Breathing in Senescent Mice through Unrestrained Barometric Plethysmography
Published on: April 28, 2020
Night-to-night variability in respiratory parameters in children and adolescents examined for obstructive sleep apnea
Marie Ørntoft1, Ida Gillberg Andersen1, Preben Homøe2
1Dept. of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Lykkebækvej 1, 4600, Køge, Denmark.
Insights
Nightly sleep studies show significant variability in obstructive sleep apnea (OSA) diagnosis and severity in children. This night-to-night variability in pediatric OSA is clinically relevant and requires consideration during diagnosis.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
- Diagnostic Accuracy
Background:
- Obstructive sleep apnea (OSA) diagnosis in children typically relies on single-night polysomnography (PSG).
- Limited research exists on night-to-night variability of respiratory parameters using type 3 sleep monitors in pediatric populations.
- Understanding this variability is crucial for accurate OSA diagnosis in adolescents.
Purpose of the Study:
- To investigate the night-to-night variability of respiratory parameters in children and adolescents using a portable type 3 sleep monitor.
- To assess the clinical relevance of this observed night-to-night variability in diagnosing pediatric OSA.
Main Methods:
- Utilized data from 30 children and adolescents with overweight/obesity and OSA, with two consecutive nights of sleep recordings.
- Employed the Nox T3 portable sleep monitor for home-based sleep examinations.
- Analyzed respiratory parameters using paired t-tests/Wilcoxon signed-rank tests and graphical methods (scatter/Bland-Altman plots).
Main Results:
- No statistically significant differences were found in respiratory parameters between nights (p > 0.05).
- However, significant night-to-night variability in the apnea-hypopnea index (AHI) was observed in some participants.
- A substantial percentage of participants (27%) changed diagnostic category, and 50% changed severity category between nights.
Conclusions:
- Night-to-night variability in AHI measurements can lead to changes in OSA diagnosis and severity classification in children and adolescents.
- This variability is clinically relevant and should be considered in the diagnostic process for pediatric OSA.
- Further research may explore strategies to account for this variability in clinical practice.
Introduction:
The diagnosis of obstructive sleep apnea (OSA) is routinely based on just a single night's sleep examination. The night-to-night variability in children and adolescents has previously been investigated using type 4 sleep monitors or PSG. However, there is a lack of studies investigating the night-to-night variability when using type 3 sleep monitors. Therefore, the main purpose was to investigate the night-to-night variability in respiratory parameters in children and adolescents using a portable type 3 monitor. Furthermore, the purpose was to investigate the clinical relevance of night-to-night variability.
Methods:
The study population was recruited from an ongoing research project concerning the effect of weight loss in children and adolescents with OSA and overweight/obesity. The inclusion criterion was the successful recording of two consecutive nights of sleep. Sleep examinations were recorded at home using the Nox T3 device and then blindly scored by the same registered polysomnographic technologist. To compare the respiratory parameters measured each night, a paired t-test or a Wilcoxon signed-rank test was used. The apnea-hypopnea index (AHI) was further described graphically with a scatter plot and a Bland-Altman plot. The presence and severity of OSA were described in tables.
Results:
A total of 30 children and adolescents with a median age of 14.8 years were included. When comparing respiratory parameters between nights, all p-values derived from paired t-tests and Wilcoxon signed-rank tests were >0.05. When considering the graphical depictions of AHI, it was evident that for some participants AHI measurements varied widely from night to night. Regarding the presence of OSA, 27% of participants changed diagnostic category between nights and 40% of those with a normal AHI on the first night had OSA on the second night. Regarding OSA severity, 50% of participants changed severity category between nights.
Conclusions:
AHI measurements varied widely between nights in some children and adolescents leading to frequent changes in both diagnosis and severity of OSA from night to night. We therefore suggest the presence of a clinically relevant night-to-night variability which should be taken into account when diagnosing pediatric OSA.
Related Concept Videos
01:26Respiratory Volumes and Capacities I
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
01:21Sleep Apnea
The condition is more prevalent among...
01:27Physical Assessment of the Respiratory Tract II: Inspection
Chest Configuration
The chest configuration...
01:30Alterations in Respiration II
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation: