Screening of obstructive and central apnoea/hypopnoea in children using variability: a preliminary study.
OBJECTIVE
Polysomnography (PSG) is the current standard protocol for sleep disordered breathing (SDB) investigation in children. Presently, there are limited reliable screening tests for both central (CE) and obstructive (OE) respiratory events. This study compared three indices, derived from pulse oximetry and electrocardiogram (ECG), with the PSG gold standard. These indices were heart rate (HR) variability, arterial blood oxygen de-saturation (SaO2) and pulse transit time (PTT).


METHODS
15 children (12 male) from routine PSG studies were recruited (aged 3-14 years). The characteristics of the three indices were based on known criteria for respiratory events (RPE). Their estimation singly and in combination was evaluated with simultaneous scored PSG recordings.


RESULTS
215 RPE and 215 tidal breathing events were analysed. For OE, the obtained sensitivity was HR (0.703), SaO2 (0.047), PTT (0.750), considering all three indices (0) and either of the indices (0.828) while specificity was (0.891), (0.938), (0.922), (0.953) and (0.859) respectively. For CE, the sensitivity was HR (0.715), SaO2 (0.278), PTT (0.662), considering all indices (0.040) and either of the indices (0.868) while specificity was (0.815), (0.954), (0.901), (0.960) and (0.762) accordingly.


CONCLUSIONS
Preliminary findings herein suggest that the later combination of these non-invasive indices to be a promising screening method of SDB in children.
Foo
Jong Yong A
JY
Biomedical Engineering Research Centre, Nanyang Technological University, 50 Nanyang Drive, Singapore, 637553. jong@ntu.edu.sg
Bradley
Andrew P
AP
Wilson
Stephen J
SJ
Williams
Gordon R
GR
Dakin
Carolyn
C
Cooper
David M
DM
D000293:Adolescent; D001783:Blood Flow Velocity / Q000502:physiology*; D001784:Blood Gas Analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood*; D017286:Polysomnography; D011237:Predictive Value of Tests; D011673:Pulsatile Flow / Q000502:physiology*; D020182:Sleep Apnea, Central / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology
D010100:Oxygen