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Published on: January 26, 2019
Clinical application of home sleep apnea testing in children: a prospective pilot study
Amee Revana1, Jason Vecchio1, Danielle Guffey1
1Baylor College of Medicine, Houston, Texas.
Insights
Home sleep apnea tests (HSAT) show promise for diagnosing moderate to severe obstructive sleep apnea in children. The SHOOTS questionnaire can help identify children who may benefit from HSAT screening.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Medicine
- Diagnostic Testing
Background:
- Obstructive sleep apnea (OSA) is a common sleep-disordered breathing condition in children.
- Accurate diagnosis of OSA is crucial for timely intervention and management.
- Home sleep apnea testing (HSAT) offers a potentially more accessible alternative to laboratory polysomnography (LPSG).
Purpose of the Study:
- To evaluate the sensitivity and specificity of HSAT in children diagnosed with moderate to severe OSA via LPSG.
- To assess the utility of the SHOOTS screening questionnaire in identifying children at elevated risk for OSA.
Main Methods:
- A prospective pilot study involving typically developing children with diagnosed moderate to severe OSA.
- Participants underwent two consecutive nights of sleep monitoring: HSAT followed by LPSG.
- The SHOOTS questionnaire was administered pre-study to assess OSA risk factors.
Main Results:
- HSAT demonstrated a sensitivity of 71.43% and specificity of 95.83% for identifying severe OSA (apnea-hypopnea index ≥ 10 events/h) when using specific cutoff values.
- The SHOOTS questionnaire showed a sensitivity of 85.7% and specificity of 54.2% for identifying severe OSA.
- Obesity was a common comorbidity among the study participants.
Conclusions:
- HSAT can be clinically applied with established cutoff values to identify moderate to severe obstructive sleep apnea in children.
- The SHOOTS questionnaire may serve as a valuable tool for identifying children who require further evaluation with HSAT.
Study Objectives:
(1) To determine the sensitivity and specificity of the home sleep apnea test (HSAT) performed in typically developing children who were diagnosed with moderate to severe obstructive sleep apnea during overnight attended laboratory polysomnography (LPSG). (2) To determine the utility of a screening questionnaire to identify children at increased risk for obstructive sleep apnea.
Methods:
Participants completed 2 consecutive study nights, the first night with the HSAT followed by LPSG on the second night. The SHOOTS questionnaire, composed of 6 questions (snoring, hyperactivity, obesity, observed apnea, tonsillar hypertrophy, and sleepiness) concerning sleep-disordered breathing, was administered by the clinician before the first study night.
Results:
Thirty-eight participants completed both studies. The mean age was 13.8 ± 3.0 years. Twenty (53%) were male. Most participants were obese. The mean LPSG total sleep time was 7.34 ± 1.19 hours; the mean HSAT total recording time was 8.86 ± 1.73 hours (P < .001). The median obstructive apnea-hypopnea index for LPSG and HSAT was 6.6 and 0.8 events/h, respectively. For an obstructive apnea-hypopnea index ≥ 3.1 events/h by HSAT, the sensitivity was 71.43% (95% confidence interval, 41.9-91.6) and the specificity was 95.83% (95% confidence interval, 78.9-99.9) for identifying those with an LPSG obstructive apnea-hypopnea index of ≥ 10 events/h. For a SHOOTS score with ≥ 4 "yes" responses, the sensitivity and specificity were 85.7% (95% confidence interval, 57.2-98.2) and 54.2% (95% confidence interval, 32.8-74.4), respectively, for identifying those with an LPSG obstructive apnea-hypopnea index ≥ 10 events/h.
Conclusions:
Using HSAT, we clinically applied cutoff values to identify moderate to severe obstructive sleep apnea in typically developing children. The SHOOTS questionnaire may aid in identifying children at risk for obstructive sleep apnea and who are candidates for HSAT.
Citation:
Revana A, Vecchio J, Guffey D, Minard CG, Glaze DG. Clinical application of home sleep apnea testing in children: a prospective pilot study. J Clin Sleep Med. 2022;18(2):533-540.
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