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Screening Severe Obstructive Sleep Apnea in Children with Snoring.

Hui-Shan HsiehChung-Jan KangHai-Hua ChuangMing-Ying ZhuoGuo-She LeeYu-Shu HuangLi-Pang ChuangTerry B-J KuoCheryl C-H YangLi-Ang LeeHsueh-Yu Li
Published in: Diagnostics (Basel, Switzerland) (2021)
Efficient screening for severe obstructive sleep apnea (OSA) is important for children with snoring before time-consuming standard polysomnography. This retrospective cross-sectional study aimed to compare clinical variables, home snoring sound analysis, and home sleep pulse oximetry on their predictive performance in screening severe OSA among children who habitually snored. Study 1 included 9 (23%) girls and 30 (77%) boys (median age of 9 years). Using univariate logistic regression models, 3% oxygen desaturation index (ODI3) ≥ 6.0 events/h, adenoidal-nasopharyngeal ratio (ANR) ≥ 0.78, tonsil size = 4, and snoring sound energy of 801-1000 Hz ≥ 22.0 dB significantly predicted severe OSA in descending order of odds ratio. Multivariate analysis showed that ODI3 ≥ 6.0 events/h independently predicted severe pediatric OSA. Among several predictive models, the combination of ODI3, tonsil size, and ANR more optimally screened for severe OSA with a sensitivity of 91% and a specificity of 94%. In Study 2 (27 (27%) girls and 73 (73%) boys; median age, 7 years), this model was externally validated to predict severe OSA with an accuracy of 76%. Our results suggested that home sleep pulse oximetry, combined with ANR, can screen for severe OSA more optimally than ANR and tonsil size among children with snoring.
Keyphrases
  • obstructive sleep apnea
  • positive airway pressure
  • early onset
  • young adults
  • sleep apnea
  • healthcare
  • blood pressure
  • physical activity
  • drug induced
  • sleep quality
  • data analysis