Identification of sleep-disordered breathing in children: variation with event definition.
OBJECTIVE
To determine the effect of varying approaches to the measurement of the respiratory disturbance index (RDI) on identification of sleep disordered breathing (SDB) in children.


METHODS
Cross-sectional study of SDB in a well-characterized birth cohort (stratified for term and preterm birth) participating in longitudinal studies of cognition and behavior.


METHODS
Community-based; overnight studies conducted in participant's homes.


METHODS
433 children, ages 8-11 years, un-referred for clinical assessment of SDB.


METHODS
N/A.


RESULTS
Participants underwent unattended overnight in-home recording of respiratory inductance plethysmography, pulse oximetry, body position, and heart rate. The relationships among RDIs derived from various definitions of apnea and hypopneas and thresholds for frequency of events were assessed. Median RDI varied by more than 20-fold for definitions using the more liberal criteria for event definition (all respiratory events; i.e., central or obstructive events and hypopneas with no requirement for associated desaturation) to the most conservative definition (using obstructive apneas only or obstructive apnea and hypopneas requiring a 5% associated desaturation). Prevalence estimates for SDB based on RDIs that included central apneas were 40% to 140% higher than those that excluded central apneas.


CONCLUSIONS
Different approaches for quantifying RDI contribute to substantial variability in identification and classification of SDB in children and will lead to discrepant estimates of its presence and severity.
Tang
Jenny  P L
J
Department of Pediatrics, KK Women's and Children's Hospital, Singapore.
Rosen
Carol L
CL
Larkin
Emma K
EK
DiFiore
Juliann M
JM
Arnold
Jean L
JL
Surovec
Susan A
SA
Youngblut
JoAnne M
JM
Redline
Susan
S
D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000453:epidemiology