title: Validation of Polyvinylidene Fluoride Impedance Sensor for Respiratory Event Classification during Polysomnography in Children.
abstract: OBJECTIVE
  Polysomnography is the gold standard for diagnosis and characterization of severity of sleep-disordered breathing. Accuracy and reliability of the technology used are critical to the integrity of the study's interpretation. Strict criteria for obstructive sleep apnea in children are lacking and diagnosis often requires consideration of frequency of respiratory events in addition to other measures. Current American Academy of Sleep Medicine recommendations for pediatric patients includes use of respiratory inductance plethysmography (RIP) belts, whereas polyvinylidene fluoride (PVDF) belts are currently only acceptable for use in adults. We hypothesized that PVDF belts would be equally effective as RIP belts for detection of respiratory effort and events in children.
  
  
  METHODS
  Children ages 2-17 y were recruited from a large pediatric tertiary referral center after obtaining consent for participation. Fifty subjects were recruited (average age, 7.8 y). Clinically relevant limits of agreement were predetermined to be a difference in total count of obstructive or central apneas or hypopneas of ± 5 events.
  
  
  RESULTS
  Scoring of respiratory events was not significantly different by belt type based on Bland-Altman plots of total apnea-hypopnea index and obstructive apneas. Obstructive hypopneas scoring ranged beyond our clinical limit of agreement. Findings in obese subjects were consistent with the larger sample with the exception of an increase in outliers. Artifact amount was comparable (RIP 10.9% ± 22.5% and PVDF 10.5% ± 19.5%).
  
  
  CONCLUSIONS
  Based on these findings, PVDF belts appear to be as effective as RIP belts in detection of respiratory effort and events in children.
  
  
  CONCLUSIONS
  A commentary on this article appears in this issue on page 159.
authors.affiliation: Children's Respiratory and Critical Care Specialists, Minneapolis, MN.
authors.forename: Anne G
authors.initials: AG
authors.lastname: Griffiths
authors.affiliation: University of Illinois Hospital and Health Sciences System, University of Illinois College of Medicine, Chicago, IL.
authors.forename: Pallavi P
authors.initials: PP
authors.lastname: Patwari
authors.affiliation: Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.|Northwestern University, Feinberg School of Medicine, Evanston, IL.
authors.forename: Darius A
authors.initials: DA
authors.lastname: Loghmanee
authors.affiliation: Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Balog
authors.affiliation: Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.|Northwestern University, Feinberg School of Medicine, Evanston, IL.
authors.forename: Irina
authors.initials: I
authors.lastname: Trosman
authors.affiliation: Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.|Northwestern University, Feinberg School of Medicine, Evanston, IL.
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Sheldon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography / Q000295:instrumentation* / Q000379:methods*; D011145:Polyvinyls; D011446:Prospective Studies; D015203:Reproducibility of Results; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D005465:Fluorocarbon Polymers
chemical_list: D011145:Polyvinyls; C024865:polyvinylidene fluoride; D005465:Fluorocarbon Polymers
keywords: obstructive sleep apnea; pediatrics; polysomnogram; respiratory monitoring; sleep-disordered breathing