Role of overnight oximetry in assessing the severity of obstructive sleep apnoea in typically developing children: a multicentre study
Role of overnight oximetry in assessing the severity of obstructive sleep apnoea in typically developing children: a multicentre study
Background and objective: cardiorespiratory polygraphy (CRP) is the predominant technology used to diagnose obstructive sleep apnoea (OSA) in tertiary centres in the UK. Nocturnal pulse oximetry (NPO) is, however, cheaper and more accessible. This study evaluated the ability of NPO indices to predict OSA in typically developing (TD) children.
Methods: indices from simultaneous NPO and CRP recordings were compared in TD children (aged 1-16 years) referred to evaluate OSA in three tertiary centres. OSA was defined as an obstructive apnoea-hypopnoea index (OAHI) ≥1 event/hour. Receiver operating characteristic curves assessed the diagnostic accuracy of NPO indices including ODI3 (3% Oxygen Desaturation Index, ODI4 (4% Oxygen Desaturation Index), delta 12 s index and minimum oxygen saturation. Two-by-two tables were generated to determine the sensitivities and specificities of whole number cut-off values for predicting OAHIs ≥1, 5 and 10 events/hour.
Results: recordings from 322 TD children, 197 male (61.2%), median age 4.9 years (range 1.1-15.6), were reviewed. OAHI was ≥1/hour in 144 (44.7%), ≥5/hour in 61 (18.9%) and ≥10/hour in 28 (8.7%) cases. ODI3 and ODI4 had the best diagnostic accuracy. ODI3 ≥7/hour and ODI4 ≥4/hour predicted OSA in TD children with sensitivities/specificities of 57.6%/85.4% and 46.2%/91.6%, respectively. ODI3 ≥8/hour was the best predictor of OAHI ≥5/hour (sensitivity 82.0%, specificity 84.3%).
Conclusion: raised ODI3 and ODI4 predict OSA in TD children with high specificity but variable sensitivity. NPO may be an alternative to diagnose moderate-severe OSA if access to CRP is limited. Low sensitivities to detect mild OSA mean that confirmatory CRP is needed if NPO is normal.
Sleep, Technology, Paediatrics
308-313
Selby, Anna
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Buchan, Elise
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Davies, Matthew
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Hill, Catherine M.
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Kingshott, Ruth N.
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Langley, Ross J.
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McGovern, Julia
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Presslie, Callum
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Senior, Emily
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Shinde, Supriya Suresh
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Yuen, Ho Ming
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Samuels, Martin
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Evans, Hazel J.
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19 March 2024
Selby, Anna
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Buchan, Elise
88e7fc9e-fa36-4baa-b878-44346cbab4ea
Davies, Matthew
051f660d-4c35-4c84-9560-5b7279c69c05
Hill, Catherine M.
172dc851-574e-4815-9c5e-4de4dae9fc35
Kingshott, Ruth N.
d93170f2-b232-4296-b5af-cd2856f1f64a
Langley, Ross J.
9b041331-ab97-4669-be42-3f8763edbac2
McGovern, Julia
de7a858a-2ee5-469c-9a37-1e00be89ec54
Presslie, Callum
fcd54706-1a09-4319-bdbd-4e8c03511f9b
Senior, Emily
c2d43e4a-0301-4526-8657-1c0a6eb2e875
Shinde, Supriya Suresh
9c38acbb-364f-4cc6-a643-ace2dfd8bdee
Yuen, Ho Ming
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Samuels, Martin
7eab1aea-ed30-4d6f-8306-a4c8168ed6af
Evans, Hazel J.
11506bb3-ce57-41fa-9966-0b22131a1a35
Selby, Anna, Buchan, Elise, Davies, Matthew, Hill, Catherine M., Kingshott, Ruth N., Langley, Ross J., McGovern, Julia, Presslie, Callum, Senior, Emily, Shinde, Supriya Suresh, Yuen, Ho Ming, Samuels, Martin and Evans, Hazel J.
(2024)
Role of overnight oximetry in assessing the severity of obstructive sleep apnoea in typically developing children: a multicentre study.
Archives of Disease in Childhood, 109 (4), , [326191].
(doi:10.1136/archdischild-2023-326191).
Abstract
Background and objective: cardiorespiratory polygraphy (CRP) is the predominant technology used to diagnose obstructive sleep apnoea (OSA) in tertiary centres in the UK. Nocturnal pulse oximetry (NPO) is, however, cheaper and more accessible. This study evaluated the ability of NPO indices to predict OSA in typically developing (TD) children.
Methods: indices from simultaneous NPO and CRP recordings were compared in TD children (aged 1-16 years) referred to evaluate OSA in three tertiary centres. OSA was defined as an obstructive apnoea-hypopnoea index (OAHI) ≥1 event/hour. Receiver operating characteristic curves assessed the diagnostic accuracy of NPO indices including ODI3 (3% Oxygen Desaturation Index, ODI4 (4% Oxygen Desaturation Index), delta 12 s index and minimum oxygen saturation. Two-by-two tables were generated to determine the sensitivities and specificities of whole number cut-off values for predicting OAHIs ≥1, 5 and 10 events/hour.
Results: recordings from 322 TD children, 197 male (61.2%), median age 4.9 years (range 1.1-15.6), were reviewed. OAHI was ≥1/hour in 144 (44.7%), ≥5/hour in 61 (18.9%) and ≥10/hour in 28 (8.7%) cases. ODI3 and ODI4 had the best diagnostic accuracy. ODI3 ≥7/hour and ODI4 ≥4/hour predicted OSA in TD children with sensitivities/specificities of 57.6%/85.4% and 46.2%/91.6%, respectively. ODI3 ≥8/hour was the best predictor of OAHI ≥5/hour (sensitivity 82.0%, specificity 84.3%).
Conclusion: raised ODI3 and ODI4 predict OSA in TD children with high specificity but variable sensitivity. NPO may be an alternative to diagnose moderate-severe OSA if access to CRP is limited. Low sensitivities to detect mild OSA mean that confirmatory CRP is needed if NPO is normal.
Text
The Role of Overnight Oximetry in Assessing the Severity of Obstructive Sleep Apnoea in Children- Accepted Manuscript
- Accepted Manuscript
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Accepted/In Press date: 18 December 2023
e-pub ahead of print date: 22 January 2024
Published date: 19 March 2024
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Publisher Copyright:
© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords:
Sleep, Technology, Paediatrics
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Local EPrints ID: 489136
URI: http://eprints.soton.ac.uk/id/eprint/489136
ISSN: 0003-9888
PURE UUID: e0bf336d-0b49-4553-8c45-fac51f6d4d3b
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Date deposited: 15 Apr 2024 16:48
Last modified: 02 Nov 2024 02:57
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Contributors
Author:
Anna Selby
Author:
Elise Buchan
Author:
Matthew Davies
Author:
Catherine M. Hill
Author:
Ruth N. Kingshott
Author:
Ross J. Langley
Author:
Julia McGovern
Author:
Callum Presslie
Author:
Emily Senior
Author:
Supriya Suresh Shinde
Author:
Martin Samuels
Author:
Hazel J. Evans
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