Comparison of home oximetry monitoring with laboratory polysomnography in children.
OBJECTIVE
To measure the accuracy and reliability of a portable home oximetry monitor with an automated analysis for the diagnosis of obstructive sleep apnea (OSA) in children.


METHODS
Prospective cohort study.


METHODS
Alberta Lung Association Sleep Center, Alberta Children's Hospital Sleep Clinic.


METHODS
Consecutive, otherwise healthy children, aged 4 to 18 years, presenting to the Pediatric Sleep Service at the Alberta Children's Hospital for assessment of possible OSA.


METHODS
All subjects underwent 2 nights of monitoring in the home with an oximetry-based portable monitor with an automatic internal scoring algorithm. A third night of monitoring was done simultaneously with computerized laboratory polysomnography according to American Thoracic Society guidelines.


RESULTS
Both test-retest reliability of the portable monitor-based desaturation index (DI) between 2 nights at home and between laboratory and home were high using the Bland and Altman analysis (mean agreement, 0.32 and 0.64; limits of agreement, - 8.00 to 8.64 and - 0.75 to 6.50, respectively). The polysomnographic apnea-hypopnea index (AHI) agreed poorly with the portable monitor DI (mean difference, 1.27; limits of agreement, - 12.02 to 15.02). The sensitivity and specificity of the monitor for the identification of moderate sleep apnea (polysomnography AHI > 5/h) were 67% and 60%, respectively.


CONCLUSIONS
Portable monitoring based only on oximetry alone is not adequate for the identification of OSA in otherwise healthy children.
Kirk
Valerie G
VG
Department of Pediatrics, University of Calgary, Calgary, AB, Canada. val.kirk@calgaryhealthregion.ca
Bohn
Shelly G
SG
Flemons
W Ward
WW
Remmers
John E
JE
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008297:Male; D010092:Oximetry / Q000295:instrumentation; D017286:Polysomnography; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*