Related Experiment Video

Updated: Oct 30, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

20.1K

Screening Severe Obstructive Sleep Apnea in Children with Snoring

Hui-Shan Hsieh1,2, Chung-Jan Kang1,2,3, Hai-Hua Chuang3,4,5

  • 1Sleep Center, Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan 33305, Taiwan.

Diagnostics (Basel, Switzerland)
|July 2, 2021
PubMed

Insights

Efficiently screen children for severe obstructive sleep apnea (OSA) using home sleep pulse oximetry and adenoidal-nasopharyngeal ratio (ANR). This combination offers a more optimal approach than traditional methods for diagnosing OSA in pediatric patients who snore.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Diagnostic Accuracy

Background:

  • Obstructive sleep apnea (OSA) significantly impacts children's health.
  • Early and efficient screening for severe OSA in snoring children is crucial.
  • Standard polysomnography is time-consuming and resource-intensive.

Purpose of the Study:

  • To compare the predictive performance of clinical variables, home snoring sound analysis, and home sleep pulse oximetry for severe OSA in children.
  • To identify the most effective screening tools for severe pediatric OSA.
  • To validate a predictive model for severe OSA in a pediatric cohort.

Main Methods:

  • Retrospective cross-sectional study involving two cohorts of children with habitual snoring.
  • Univariate and multivariate logistic regression analyses were used to assess predictors of severe OSA.
  • Key variables included 3% oxygen desaturation index (ODI3), adenoidal-nasopharyngeal ratio (ANR), tonsil size, and snoring sound energy.
  • A predictive model combining ODI3, tonsil size, and ANR was developed and externally validated.

Main Results:

  • Home sleep pulse oximetry (ODI3 ≥ 6.0 events/h) and adenoidal-nasopharyngeal ratio (ANR ≥ 0.78) were significant predictors of severe OSA.
  • A combined model of ODI3, tonsil size, and ANR demonstrated high sensitivity (91%) and specificity (94%) in Study 1.
  • External validation in Study 2 showed a 76% accuracy for the combined model.
  • Home sleep pulse oximetry combined with ANR showed superior screening performance compared to ANR and tonsil size alone.

Conclusions:

  • Home sleep pulse oximetry, particularly the 3% oxygen desaturation index (ODI3), is a valuable tool for screening severe pediatric OSA.
  • Combining ODI3 with adenoidal-nasopharyngeal ratio (ANR) and tonsil size provides an optimal screening strategy.
  • This approach offers a more efficient and accessible alternative to polysomnography for identifying severe OSA in children who snore.

Keywords:
adenoidal-nasopharyngeal ratiochildrenobstructive sleep apneaoxygen desaturation indexsnoring sound energytonsil size

More Related Videos

Image Acquisition using Portable Sonography for Emergency Airway Management07:31

Image Acquisition using Portable Sonography for Emergency Airway Management

Published on: September 28, 2022

2.6K
Conducting Respiratory Oscillometry in an Outpatient Setting14:49

Conducting Respiratory Oscillometry in an Outpatient Setting

Published on: April 8, 2022

7.8K

Related Concept Videos

Sleep Apnea01:21

Sleep Apnea

Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
262
Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary Resuscitation II: ACLS Airway Management

Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
225
Assessment of Airway, Skin Color, and Use of Accessory Muscles01:30

Assessment of Airway, Skin Color, and Use of Accessory Muscles

A thorough assessment of respiratory health is paramount in clinical settings to identify and manage respiratory distress and ensure adequate oxygenation. This article elaborates on the critical aspects of respiratory evaluation, including airway assessment, skin color examination, and the observation of accessory muscle use, which are integral to effectively diagnosing and managing patients with respiratory conditions.
Introduction
The initial evaluation of a patient's respiratory system...
1.2K
Suctioning the Oropharyngeal Airway01:25

Suctioning the Oropharyngeal Airway

In preparing for oropharyngeal airway suctioning, a nurse must gather all necessary equipment, including a suction unit with tubing, a prepackaged suction kit, sterile gloves, water or saline for irrigation, a water-soluble lubricant, and additional personal protective equipment (such as a gown, mask, and goggles) to control infections.
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
495
Suctioning the Nasopharyngeal Airway01:29

Suctioning the Nasopharyngeal Airway

Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
1.5K
Respiratory Assessment: Purpose and Indications01:19

Respiratory Assessment: Purpose and Indications

Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
1.4K