Michelet Marine, Blanchon Sylvain, Guinand Stéphane, Ruchonnet-Métrailler Isabelle, Mornand Anne, Cao Van Hélène, Barazzone-Argiroffo Constance, Corbelli Regula
Pediatric Pulmonology Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.
Pediatric Ear-Nose-Throat Unit, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Sleep Med. 2020 Apr;68:146-152. doi: 10.1016/j.sleep.2019.11.1264. Epub 2019 Dec 17.
Sleep-disordered breathing (SDB) in children is common. Interest in sleep tests, such as polygraphy (PG), which can be performed in a non-attended setting, are gaining is increasing. PG has, however, been little studied in children with co-morbidities other than obstructive sleep apnea (OSA), and in particular, if performed in a non-attended setting. We report on the feasibility and interpretability of implementing PGs at home versus in hospital.
PGs were analyzed according to the setting (hospital or home) and sequence (initial or subsequent) in which they were performed. Non-interpretability was defined as absent or unreliable oxygen saturation by pulse oximetry (SpO), or airflow and respiratory inductance plethysmography flow trace signals during the time analyzed.
We retrospectively analyzed 400 PGs; 332/400 were initial PGs. Indications were: suspected OSA (65%), obesity (13%), craniofacial malformations (5%), neuromuscular disease (4%), and other (13%) which included prematurity. 16% were recorded in hospitals and 84% at home. The mean age was 5.7 ± 5.8 years and 7.3 ± 4.5 years for the hospital and home groups, respectively. Interpretability was similar in both settings (87%). In the 68 subsequent PGs, interpretability was 84% when performed for follow-up and 96% when repeated for non-interpretability. Non-interpretability was predominantly due to a failure of the SpO channel.
PG performed at home is both feasible and interpretable for a variety of indications. Non-interpretability was not predictable in association with the setting, anthropometric data, or indication, independently of the sequence (initial or subsequent PG) in which the parameters were analyzed.
儿童睡眠呼吸障碍(SDB)很常见。对可在无人值守环境下进行的睡眠测试,如多导睡眠图(PG)的兴趣日益增加。然而,PG在患有阻塞性睡眠呼吸暂停(OSA)以外合并症的儿童中研究较少,尤其是在无人值守环境下进行时。我们报告了在家中与在医院进行PG的可行性和可解释性。
根据PG的实施环境(医院或家中)和顺序(初次或后续)进行分析。不可解释性定义为在分析期间脉搏血氧饱和度(SpO)、气流和呼吸感应体积描记法流量信号缺失或不可靠。
我们回顾性分析了400份PG;其中332/400份为初次PG。适应证包括:疑似OSA(65%)、肥胖(13%)、颅面畸形(5%)、神经肌肉疾病(4%)以及其他(13%),包括早产。16%在医院记录,84%在家中记录。医院组和家庭组的平均年龄分别为5.7±5.8岁和7.3±4.5岁。两种环境下的可解释性相似(87%)。在68份后续PG中,用于随访时的可解释性为84%,因不可解释性而重复检查时为96%。不可解释性主要是由于SpO通道故障。
在家中进行的PG对于多种适应证既可行又可解释。不可解释性与环境、人体测量数据或适应证无关,且与分析参数的顺序(初次或后续PG)无关,无法预测。