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The investigation of sleep disordered breathing: seeing through a glass, darkly?

The investigation of sleep disordered breathing: seeing through a glass, darkly?
The investigation of sleep disordered breathing: seeing through a glass, darkly?
Timely diagnosis and treatment of obstructive sleep apnoea (OSA) in childhood is important to prevent morbidity and increased healthcare utilisation.1 In this issue, Burke et al2 highlight an important clinical question—how to best diagnose OSA in children, asking the question: is one night of oximetry enough? They note the limited availability of polysomnography, the international gold standard diagnostic test3 for OSA and that pulse oximetry is widely available.

However, widespread availability of oximetry risks widespread misinterpretation. It is crucial to understand that not all oximeters are ‘born equal’ and the technology available may have significant limitations. The diagnostic yield of any oximeter will depend crucially on the device used and its settings, the scoring criteria applied to the trace, alongside the clinical interpretation of the data. Modern oximeters are able to detect and remove motion artefact, which is critical in restless young children (figure 1). Oximeters need to be set with short averaging times (usually maximum 3?s) to avoid smoothing out of brief desaturation events (figure 2). McGill scoring criteria are recommended with a score >1 (three or more clusters of desaturation events ?4% and at least three desaturations to <90%) being indicative of OSA,3 but as noted by Burke and colleagues, …
Oximetry
0003-9888
1082-1083
Hill, Catherine
867cd0a0-dabc-4152-b4bf-8e9fbc0edf8d
Evans, Hazel
722c5b0a-e32d-431b-ab45-7050bee983d1
Hill, Catherine
867cd0a0-dabc-4152-b4bf-8e9fbc0edf8d
Evans, Hazel
722c5b0a-e32d-431b-ab45-7050bee983d1

Hill, Catherine and Evans, Hazel (2016) The investigation of sleep disordered breathing: seeing through a glass, darkly? Archives of Disease in Childhood, 101, 1082-1083. (doi:10.1136/archdischild-2016-310483).

Record type: Editorial

Abstract

Timely diagnosis and treatment of obstructive sleep apnoea (OSA) in childhood is important to prevent morbidity and increased healthcare utilisation.1 In this issue, Burke et al2 highlight an important clinical question—how to best diagnose OSA in children, asking the question: is one night of oximetry enough? They note the limited availability of polysomnography, the international gold standard diagnostic test3 for OSA and that pulse oximetry is widely available.

However, widespread availability of oximetry risks widespread misinterpretation. It is crucial to understand that not all oximeters are ‘born equal’ and the technology available may have significant limitations. The diagnostic yield of any oximeter will depend crucially on the device used and its settings, the scoring criteria applied to the trace, alongside the clinical interpretation of the data. Modern oximeters are able to detect and remove motion artefact, which is critical in restless young children (figure 1). Oximeters need to be set with short averaging times (usually maximum 3?s) to avoid smoothing out of brief desaturation events (figure 2). McGill scoring criteria are recommended with a score >1 (three or more clusters of desaturation events ?4% and at least three desaturations to <90%) being indicative of OSA,3 but as noted by Burke and colleagues, …

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Accepted/In Press date: 5 August 2016
e-pub ahead of print date: 1 September 2016
Published date: 1 September 2016
Keywords: Oximetry
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 401662
URI: https://eprints.soton.ac.uk/id/eprint/401662
ISSN: 0003-9888
PURE UUID: f77742a8-7553-43ab-b34f-36f1fc6858ad
ORCID for Catherine Hill: ORCID iD orcid.org/0000-0003-2372-5904

Catalogue record

Date deposited: 19 Oct 2016 10:14
Last modified: 10 Dec 2019 01:51

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