Improving detection of obstructive sleep apnoea by overnight oximetry in children using pulse rate parameters

Dg Zuraini Hj Sahadan, Margot J Davey, Rosemary Sylvia Claire Horne, Gillian Michelle Nixon

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)

Abstract

Overnight oximetry is a simple tool for investigation of obstructive sleep apnoea (OSA) in children, but only severe cases will be detected, and children with obstructive events resulting in arousal, but not desaturation, will have a normal (inconclusive) result. We hypothesised that pulse rate rises using pulse rate indices per hour (PRI) and pulse rate standard deviation (PR-SD) automatically calculated from commercially available software would improve oximetry as a diagnostic tool. METHODS: Children having home overnight oximetry for suspected OSA were identified over 12 months, and those with a normal result who went on to have polysomnography (PSG) were included. Oximetry, including PR-SD and PRI (rises of 8, 10 and 15 beats/min per hour), was analyzed using commercially available software. PR parameters were compared between those with OSA (obstructive apnoea-hypopnoea index (OAHI) >1 event/h) and those without OSA. RESULTS: One hundred sixteen children had normal oximetry, of whom 93 (median age 4.5 years; 55 M) had PSG. Fifty-seven of 93 (61 ) children had OSA (median OAHI 4.5 events/h, range 1.1-24). PR-SD was not different between the OSA and non-OSA groups (p = 0.87). PRI tended to be higher in those with OSA, but there was considerable overlap between the groups: PRI-8 (mean +/- SD 58.5 +/- 29.0/h in OSA group vs 48.6 +/- 20.2/h in non-OSA group, p = 0.07), PRI-10 (45.1 +/- 25.0 vs 36.2 +/- 16.7, p = 0.06) and PRI-15 (24.4 +/- 14.5 vs 18.9 +/- 9.0, p = 0.04). A PRI-15 threshold of >35/h had specificity of 97 for OSA. CONCLUSION: The PRI-15 shows promise as an indicator of OSA in children with normal oximetry.
Original languageEnglish
Pages (from-to)1409 - 1414
Number of pages6
JournalSleep and Breathing
Volume19
Issue number4
DOIs
Publication statusPublished - 2015

Cite this

@article{8c03aa4509d446dcaa49d684ecbc7cb3,
title = "Improving detection of obstructive sleep apnoea by overnight oximetry in children using pulse rate parameters",
abstract = "Overnight oximetry is a simple tool for investigation of obstructive sleep apnoea (OSA) in children, but only severe cases will be detected, and children with obstructive events resulting in arousal, but not desaturation, will have a normal (inconclusive) result. We hypothesised that pulse rate rises using pulse rate indices per hour (PRI) and pulse rate standard deviation (PR-SD) automatically calculated from commercially available software would improve oximetry as a diagnostic tool. METHODS: Children having home overnight oximetry for suspected OSA were identified over 12 months, and those with a normal result who went on to have polysomnography (PSG) were included. Oximetry, including PR-SD and PRI (rises of 8, 10 and 15 beats/min per hour), was analyzed using commercially available software. PR parameters were compared between those with OSA (obstructive apnoea-hypopnoea index (OAHI) >1 event/h) and those without OSA. RESULTS: One hundred sixteen children had normal oximetry, of whom 93 (median age 4.5 years; 55 M) had PSG. Fifty-seven of 93 (61 ) children had OSA (median OAHI 4.5 events/h, range 1.1-24). PR-SD was not different between the OSA and non-OSA groups (p = 0.87). PRI tended to be higher in those with OSA, but there was considerable overlap between the groups: PRI-8 (mean +/- SD 58.5 +/- 29.0/h in OSA group vs 48.6 +/- 20.2/h in non-OSA group, p = 0.07), PRI-10 (45.1 +/- 25.0 vs 36.2 +/- 16.7, p = 0.06) and PRI-15 (24.4 +/- 14.5 vs 18.9 +/- 9.0, p = 0.04). A PRI-15 threshold of >35/h had specificity of 97 for OSA. CONCLUSION: The PRI-15 shows promise as an indicator of OSA in children with normal oximetry.",
author = "Sahadan, {Dg Zuraini Hj} and Davey, {Margot J} and Horne, {Rosemary Sylvia Claire} and Nixon, {Gillian Michelle}",
year = "2015",
doi = "10.1007/s11325-014-1108-4",
language = "English",
volume = "19",
pages = "1409 -- 1414",
journal = "Sleep and Breathing",
issn = "1520-9512",
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}

Improving detection of obstructive sleep apnoea by overnight oximetry in children using pulse rate parameters. / Sahadan, Dg Zuraini Hj; Davey, Margot J; Horne, Rosemary Sylvia Claire; Nixon, Gillian Michelle.

In: Sleep and Breathing, Vol. 19, No. 4, 2015, p. 1409 - 1414.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Improving detection of obstructive sleep apnoea by overnight oximetry in children using pulse rate parameters

AU - Sahadan, Dg Zuraini Hj

AU - Davey, Margot J

AU - Horne, Rosemary Sylvia Claire

AU - Nixon, Gillian Michelle

PY - 2015

Y1 - 2015

N2 - Overnight oximetry is a simple tool for investigation of obstructive sleep apnoea (OSA) in children, but only severe cases will be detected, and children with obstructive events resulting in arousal, but not desaturation, will have a normal (inconclusive) result. We hypothesised that pulse rate rises using pulse rate indices per hour (PRI) and pulse rate standard deviation (PR-SD) automatically calculated from commercially available software would improve oximetry as a diagnostic tool. METHODS: Children having home overnight oximetry for suspected OSA were identified over 12 months, and those with a normal result who went on to have polysomnography (PSG) were included. Oximetry, including PR-SD and PRI (rises of 8, 10 and 15 beats/min per hour), was analyzed using commercially available software. PR parameters were compared between those with OSA (obstructive apnoea-hypopnoea index (OAHI) >1 event/h) and those without OSA. RESULTS: One hundred sixteen children had normal oximetry, of whom 93 (median age 4.5 years; 55 M) had PSG. Fifty-seven of 93 (61 ) children had OSA (median OAHI 4.5 events/h, range 1.1-24). PR-SD was not different between the OSA and non-OSA groups (p = 0.87). PRI tended to be higher in those with OSA, but there was considerable overlap between the groups: PRI-8 (mean +/- SD 58.5 +/- 29.0/h in OSA group vs 48.6 +/- 20.2/h in non-OSA group, p = 0.07), PRI-10 (45.1 +/- 25.0 vs 36.2 +/- 16.7, p = 0.06) and PRI-15 (24.4 +/- 14.5 vs 18.9 +/- 9.0, p = 0.04). A PRI-15 threshold of >35/h had specificity of 97 for OSA. CONCLUSION: The PRI-15 shows promise as an indicator of OSA in children with normal oximetry.

AB - Overnight oximetry is a simple tool for investigation of obstructive sleep apnoea (OSA) in children, but only severe cases will be detected, and children with obstructive events resulting in arousal, but not desaturation, will have a normal (inconclusive) result. We hypothesised that pulse rate rises using pulse rate indices per hour (PRI) and pulse rate standard deviation (PR-SD) automatically calculated from commercially available software would improve oximetry as a diagnostic tool. METHODS: Children having home overnight oximetry for suspected OSA were identified over 12 months, and those with a normal result who went on to have polysomnography (PSG) were included. Oximetry, including PR-SD and PRI (rises of 8, 10 and 15 beats/min per hour), was analyzed using commercially available software. PR parameters were compared between those with OSA (obstructive apnoea-hypopnoea index (OAHI) >1 event/h) and those without OSA. RESULTS: One hundred sixteen children had normal oximetry, of whom 93 (median age 4.5 years; 55 M) had PSG. Fifty-seven of 93 (61 ) children had OSA (median OAHI 4.5 events/h, range 1.1-24). PR-SD was not different between the OSA and non-OSA groups (p = 0.87). PRI tended to be higher in those with OSA, but there was considerable overlap between the groups: PRI-8 (mean +/- SD 58.5 +/- 29.0/h in OSA group vs 48.6 +/- 20.2/h in non-OSA group, p = 0.07), PRI-10 (45.1 +/- 25.0 vs 36.2 +/- 16.7, p = 0.06) and PRI-15 (24.4 +/- 14.5 vs 18.9 +/- 9.0, p = 0.04). A PRI-15 threshold of >35/h had specificity of 97 for OSA. CONCLUSION: The PRI-15 shows promise as an indicator of OSA in children with normal oximetry.

UR - http://link.springer.com/article/10.1007%2Fs11325-014-1108-4

U2 - 10.1007/s11325-014-1108-4

DO - 10.1007/s11325-014-1108-4

M3 - Article

VL - 19

SP - 1409

EP - 1414

JO - Sleep and Breathing

JF - Sleep and Breathing

SN - 1520-9512

IS - 4

ER -