Related Experiment Video
Updated: Sep 11, 2025
Multi-Modal Home Sleep Monitoring in Older Adults
Published on: January 26, 2019
Home video clips compared to polygraphy for obstructive sleep apnea diagnosis in children with autism spectrum
Gianna Cox1, Sherri Lynne Katz2, Vid Bijelić3
1Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Insights
Video clips using the Monash score (MS) show high sensitivity for detecting obstructive sleep apnea (OSA) in children with autism spectrum disorder (ASD). This tool may help screen for OSA when polysomnography is challenging.
Area of Science:
- Pediatric Sleep Medicine
- Autism Spectrum Disorder Research
- Diagnostic Tool Development
Background:
- Children with autism spectrum disorder (ASD) have a higher prevalence of obstructive sleep apnea (OSA) compared to neurotypical children.
- Polysomnography (PSG), the gold standard for OSA diagnosis, is often challenging for children with ASD.
- More accessible screening tools are needed for OSA in this population.
Purpose of the Study:
- To evaluate the diagnostic characteristics of video clips for identifying OSA in children with ASD.
- To compare the effectiveness of video-based screening with other established tools.
Main Methods:
- Recruited children aged 4-18 years with ASD referred for PSG.
- Parents recorded 2-minute home video clips, scored using the Monash score (MS).
- Compared MS with Pediatric Sleep Questionnaire (PSQ), home polygraphy (PG) metrics (oAHI, ODI3), and McGill Oximetry Score (MOS) for moderate-severe OSA.
Main Results:
- The Monash score (MS) demonstrated 100% sensitivity and 63.6% specificity for moderate-severe OSA.
- MS outperformed the PSQ and MOS, with an AUC of 78.4.
- While MS showed high sensitivity, its specificity was lower, and it did not outperform ODI3.
Conclusions:
- The Monash score (MS) shows promise as a sensitive screening tool for OSA in children with ASD.
- MS may serve as a viable alternative to more challenging diagnostic methods like PSG.
- Further validation studies are required to confirm the utility of MS in clinical practice.
Introduction:
Children with autism spectrum disorder (ASD) have higher prevalence of obstructive sleep apnea (OSA) than typically developing children. Polysomnography (PSG), the gold standard test is challenging for children with ASD. Polygraphy (PG) may be better tolerated, but more accessible screening tools are needed. We evaluated diagnostic characteristics of video clips for OSA in this pilot study.
Methods:
Children 4-18 years with ASD referred for PSG for suspected OSA were recruited. Parents recorded 3 2-min home videos, scored for OSA presence using Monash score (MS, positive if ≥ 3). Participants completed the Pediatric Sleep Questionnaire (PSQ; positive if ≥ 0.33) and underwent home PG, scored by obstructive apnea hypopnea index (oAHI), oxygen desaturation index 3 % (ODI3; ≥4.3 and > 7 thresholds) and McGill Oximetry Score (MOS; positive if ≥ 2). Receiver-operator curves were used to compare diagnostic performance across tools for moderate-severe OSA (oAHI ≥5 events/hour).
Results:
26 children participated; 15 (median age 7.1) provided video clips. Median oAHI was 2.4/hr; 26.7 % had moderate-severe OSA. Fourteen (93.3 %) had PSQ ≥0.33, three had MOS ≥2. ODI3 was ≥4.3 in 7 and > 7 in 6 children. Median MS was 3.0. MS had 100 % sensitivity, 63.6 % specificity and AUC 78.4 for detecting moderate-severe OSA; average AUC increased when MS was combined with oximetry metrics.
Conclusion:
MS showed high sensitivity but low specificity in detecting moderate-severe OSA. MS outperformed PSQ and MOS, but not ODI3. MS may be a viable alternative screening tool to identify OSA in children with ASD but requires further validation.
