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Published on: December 22, 2016
Observational study to define reference ranges for the 3% oxygen desaturation index during sleep in healthy children
Jonathan Wen Yi Ong1, Daniel Williams2, Johanna C Gavlak1
1Department of Respiratory Paediatrics, Southampton Children's Hospital, Southampton, UK.
Insights
Reference ranges for the 3% oxygen desaturation index (DI3) were established in healthy children. A DI3 value below 7 is considered normal for children aged 6 months to 12 years, aiding in sleep-disordered breathing assessments.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Physiology
- Diagnostic Oximetry
Background:
- Sleep-disordered breathing (SDB) is a significant concern in pediatric populations.
- Accurate reference ranges for respiratory indices during sleep are crucial for diagnosis.
- The 3% oxygen desaturation index (DI3) is a key parameter in SDB assessment.
Purpose of the Study:
- To establish normative reference ranges for the 3% oxygen desaturation index (DI3) in healthy children.
- To define a cut-off value for normality of DI3 in pediatric sleep studies.
- To provide data for the improved assessment of sleep-disordered breathing in children.
Main Methods:
- An observational study was conducted using nocturnal home pulse oximetry in healthy children aged 6 months to 12 years.
- Parents recorded sleep times, and data were analyzed using Visi-Download software after removing artefacts and wake periods.
- Key oximetry parameters, including DI3, DI4, mean saturations (SAT50), and minimum saturations (SATmin), were measured.
Main Results:
- Data from 66 children were analyzed, with median DI3 of 2.58 and median DI4 of 0.92.
- The 95th and 97.5th centiles for DI3 were determined to be 6.43 and 7.06, respectively.
- Mean SAT50 was 97.57% and mean SATmin was 91.09%.
Conclusions:
- Normality for the 3% oxygen desaturation index (DI3) in children aged 6 months to 12 years is defined as <7.
- This reference range was established using standalone, motion-resistant pulse oximeters with short averaging times.
- These findings support the accurate diagnosis of sleep-disordered breathing in pediatric patients.
Objective:
To define reference ranges for the 3% oxygen desaturation index (DI3) in healthy children under 12 years old during sleep.
Design:
Observational.
Setting:
Home.
Subjects:
Healthy children aged 6 months to 12 years of age.
Intervention:
Nocturnal pulse oximetry at home. Parents documented sleep times. Visi-Download software (Stowood Scientific) analysed data with artefact and wake periods removed.
Main Outcome Measures:
The following oximetry parameters used in the assessment of sleep-disordered breathing conditions were measured: 3% (DI3) and 4% (DI4) oxygen desaturation indices-the number of times per hour where the oxygen saturation falls by at least 3% or 4% from baseline, mean saturations (SAT50), minimum saturations (SATmin), delta index 12 s (DI12s), and percentage time with saturations below 92% and 90%.
Results:
Seventy-nine children underwent nocturnal home pulse oximetry, from which there were 66 studies suitable for analysis. The median values for DI3 and DI4 were 2.58 (95% CI 1.96 to 3.10) and 0.92 (95% CI 0.73 to 1.15), respectively. The 95th and 97.5th centiles for DI3 were 6.43 and 7.06, respectively, which inform our cut-off value for normality. The mean values for SAT50 and SATmin were 97.57% (95% CI 97.38% to 97.76%) and 91.09% (95% CI 90.32% to 91.86%), respectively.
Conclusion:
In children aged 6 months to 12 years, we define normality of the 3% oxygen desaturation index as <7 using standalone, motion-resistant pulse oximeters with short averaging times.
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