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Pulse transit time as a diagnostic test for OSA in children with Down syndrome

Iulia Ioan1, Diane Weick2, François Sevin2

  • 1Service d'Explorations Fonctionnelles Pédiatriques, Hôpital d'Enfants, Centre Hospitalier Universitaire de Nancy, Université de Lorraine, Nancy, France.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|June 25, 2021
PubMed

Insights

Children with Down syndrome (DS) have a high risk of obstructive sleep apnea (OSA). A simplified pulse transit time polygraphy (PTT-PG) shows excellent sensitivity and specificity for diagnosing OSA in these children.

Area of Science:

  • Pediatric Sleep Medicine
  • Cardiorespiratory Physiology
  • Genetics

Background:

  • Children with Down syndrome (DS) have a significantly higher prevalence of obstructive sleep apnea (OSA) compared to the general pediatric population.
  • Diagnosis of OSA typically relies on polysomnography (PSG), which is resource-intensive and has limited accessibility.
  • There is a need for simplified, accessible diagnostic tools for OSA in children with DS.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of polygraphy coupled with pulse transit time (PTT-PG) for obstructive sleep apnea (OSA) in children with Down syndrome (DS).
  • To compare the performance of PTT-PG against standard polysomnography (PSG) in this specific pediatric population.

Main Methods:

  • A prospective, multicenter study involving 53 children with DS.
  • Simultaneous full-night PSG and PTT-PG recordings were performed.
  • Parental completion of sleep questionnaires (SDSC, PSQ) was included.
  • Sensitivity and specificity of PTT-PG for OSA diagnosis were compared to PSG.

Main Results:

  • 68% of children with DS were diagnosed with OSA by PSG (OAHI > 1 event/h).
  • PTT-PG demonstrated excellent sensitivity (1.0) when the total autonomic arousals index (PTTAI) was > 1 event/h.
  • High specificity (1.0) was observed for OAHI > 1 event/h on PTT-PG, and high specificity (0.88) was noted for the Pediatric Sleep Questionnaire.

Conclusions:

  • Over two-thirds of children with DS evaluated had OSA confirmed by PSG.
  • PTT-PG presents a simplified and effective alternative to PSG for diagnosing OSA in children with Down syndrome.
  • The PTT-PG method offers high sensitivity and specificity, improving diagnostic accessibility for this at-risk group.
Abstract

Keywords:
Down syndromeapneachildrenpulse transit timesleep

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