title: Assessment of inspiratory flow limitation in children with sleep-disordered breathing by a nasal cannula pressure transducer system.
abstract: A nasal cannula pressure transducer system identifies inspiratory flow limitation and increased upper airway resistance in adults with sleep-disordered breathing (SDB). The purpose of this study was to evaluate whether nasal cannula pressure (NCP) detects apneas and hypopneas as well as additional flow-limited events associated with increased airway resistance in children. We studied NCP in 47 patients (ages 2-14 years) referred for SDB to a university-based sleep disorders program during nocturnal polysomnography (NPSG). During NPSG, airflow was assessed simultaneously by thermistor and NCP. There was a high correlation between apneas assessed by thermistor (T) and NCP (r = 0.90, P < 0.0001), and for hypopneas using these two methods (r = 0.94, P = 0.0001). Respiratory driving pressure was indirectly measured with an esophageal pressure catheter. Flow-limited (flattened) NCP waves were associated with significantly higher driving pressure, indicating elevated upper airway resistance, compared to nonflow-limited (rounded) waves during nonrapid eye movement (NREM) (P = 0.05) and rapid eye movement (REM) (P = 0.01) sleep. Patients were classified as either having obstructive sleep apnea syndrome (OSAS) or primary snoring, based on standard NPSG criteria. NCP identified additional respiratory events with a flattened contour (FC) not detected by thermistor. NCP is a noninvasive device that identifies obstructive apneas and hypopneas as well as additional respiratory events associated with flow limitation in children.
authors.affiliation: Department of Pediatrics, Mount Sinai School of Medicine, New York, New York 10029, USA.
authors.forename: Denise
authors.initials: D
authors.lastname: Serebrisky
authors.forename: Romulo
authors.initials: R
authors.lastname: Cordero
authors.forename: John
authors.initials: J
authors.lastname: Mandeli
authors.forename: Meyer
authors.initials: M
authors.lastname: Kattan
authors.forename: Carin
authors.initials: C
authors.lastname: Lamm
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000503:physiopathology*; D000403:Airway Resistance / Q000502:physiology; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology; D009296:Nasal Cavity; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000503:physiopathology*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology; D012913:Snoring / Q000175:diagnosis; D014160:Transducers, Pressure