Iulia Ioan1, Diane Weick2, François Sevin2, Damien Sanlaville3, Bénédicte De Fréminville4, Cyril Schweitzer1, Mohamed Akkari5, Laurianne Coutier6, Benjamin Putois2, Marine Thieux2,7, Patricia Franco2,7. 1. Service d'Explorations Fonctionnelles Pédiatriques, Hôpital d'Enfants, Centre Hospitalier Universitaire de Nancy, Université de Lorraine, Nancy, France. 2. Service d'Épileptologie Clinique, des Troubles du Sommeil et de Neurologie Fonctionnelle de l'Enfant, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, and U1028, CNRL, Université de Lyon 1, Lyon, France. 3. Département de Génétique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France. 4. Service de Génétique, CHU de St. Etienne, Centre de Référence Maladies Rares des Anomalies du Développement et des Syndromes Malformatifs de l'Inter Région Centre Est, Rhône Alpes Auvergne, France. 5. Hôpital Gui de Chauliac, Montpellier, France. 6. Service de Pneumologie Infantile, Allergologie et Centre de Référence en Mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France. 7. U1028, Lyon Neuroscience Research Center (CNRL), Lyon, University Lyon 1, France.
Abstract
STUDY OBJECTIVES: Children with Down syndrome (DS) are at risk of obstructive sleep apnea (OSA), but the access to sleep lab polysomnography (PSG) is limited. Simplified techniques are needed, such as polygraphy coupled with pulse transit time (PTT-PG) that detects respiratory events and the total autonomic arousals index (PTTAI). Our objective was to assess the ability of PTT-PG compared with PSG to diagnose OSA in children with DS. METHODS: In this prospective multicenter study, patients with DS underwent a full-night PSG coupled with PTT. Sleep questionnaires (Sleep Disturbance Scale for Children and Pediatric Sleep Questionnaire) were filled by parents. PSG and PTT-PG results were compared to test their sensibility and specificity to diagnose OSA. RESULTS: A total of 53 patients with DS were included; their median age was 9.3 years. An obstructive apnea-hypopnea index (OAHI) by PSG > 1 event/h was found in 36 (68%) patients, OAHI was > 1 and < 5 events/h in 18 patients (34%), ≥ 5 and < 10 events/h in 11 patients (21%), and ≥ 10 events/h in 7 patients (13%). OAHI was larger on PSG than on PTT-PG (P = .0005). For OSA diagnosis, the sensitivity was excellent for OAHI by PTT-PG if the added total PTTAI was > 1 event/h (1.0) and the specificity was high for the Pediatric Sleep Questionnaire (0.88) and OAHI > 1 event/h on PTT-PG (1.0). CONCLUSIONS: More than two-thirds of children with DS referred for screening by a genetics specialist had OSA diagnosed by PSG. With its excellent sensitivity and specificity, PTT-PG could be a good and simplified alternative to PSG to diagnose OSA in children with DS. CITATION: Ioan I, Weick D, Sevin F, et al. Pulse transit time as a diagnostic test for OSA in children with Down syndrome. J Clin Sleep Med. 2022;18(1):119-128.
STUDY OBJECTIVES: Children with Down syndrome (DS) are at risk of obstructive sleep apnea (OSA), but the access to sleep lab polysomnography (PSG) is limited. Simplified techniques are needed, such as polygraphy coupled with pulse transit time (PTT-PG) that detects respiratory events and the total autonomic arousals index (PTTAI). Our objective was to assess the ability of PTT-PG compared with PSG to diagnose OSA in children with DS. METHODS: In this prospective multicenter study, patients with DS underwent a full-night PSG coupled with PTT. Sleep questionnaires (Sleep Disturbance Scale for Children and Pediatric Sleep Questionnaire) were filled by parents. PSG and PTT-PG results were compared to test their sensibility and specificity to diagnose OSA. RESULTS: A total of 53 patients with DS were included; their median age was 9.3 years. An obstructive apnea-hypopnea index (OAHI) by PSG > 1 event/h was found in 36 (68%) patients, OAHI was > 1 and < 5 events/h in 18 patients (34%), ≥ 5 and < 10 events/h in 11 patients (21%), and ≥ 10 events/h in 7 patients (13%). OAHI was larger on PSG than on PTT-PG (P = .0005). For OSA diagnosis, the sensitivity was excellent for OAHI by PTT-PG if the added total PTTAI was > 1 event/h (1.0) and the specificity was high for the Pediatric Sleep Questionnaire (0.88) and OAHI > 1 event/h on PTT-PG (1.0). CONCLUSIONS: More than two-thirds of children with DS referred for screening by a genetics specialist had OSA diagnosed by PSG. With its excellent sensitivity and specificity, PTT-PG could be a good and simplified alternative to PSG to diagnose OSA in children with DS. CITATION: Ioan I, Weick D, Sevin F, et al. Pulse transit time as a diagnostic test for OSA in children with Down syndrome. J Clin Sleep Med. 2022;18(1):119-128.
Authors: Richard B Berry; Rohit Budhiraja; Daniel J Gottlieb; David Gozal; Conrad Iber; Vishesh K Kapur; Carole L Marcus; Reena Mehra; Sairam Parthasarathy; Stuart F Quan; Susan Redline; Kingman P Strohl; Sally L Davidson Ward; Michelle M Tangredi Journal: J Clin Sleep Med Date: 2012-10-15 Impact factor: 4.062
Authors: Athanasios G Kaditis; Maria Luz Alonso Alvarez; An Boudewyns; Emmanouel I Alexopoulos; Refika Ersu; Koen Joosten; Helena Larramona; Silvia Miano; Indra Narang; Ha Trang; Marina Tsaoussoglou; Nele Vandenbussche; Maria Pia Villa; Dick Van Waardenburg; Silke Weber; Stijn Verhulst Journal: Eur Respir J Date: 2015-11-05 Impact factor: 16.671