儿童家庭睡眠呼吸暂停测试的临床应用：一项前瞻性试点研究。

Clinical application of home sleep apnea testing in children: a prospective pilot study.

机构信息

Baylor College of Medicine, Houston, Texas.

出版信息

J Clin Sleep Med. 2022 Feb 1;18(2):533-540. doi: 10.5664/jcsm.9650.

DOI:10.5664/jcsm.9650

PMID:34534072

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8805000/

Abstract

STUDY OBJECTIVES

(1) To determine the sensitivity and specificity of the home sleep apnea test (HSAT) performed in typically developing children who were diagnosed with moderate to severe obstructive sleep apnea during overnight attended laboratory polysomnography (LPSG). (2) To determine the utility of a screening questionnaire to identify children at increased risk for obstructive sleep apnea.

METHODS

Participants completed 2 consecutive study nights, the first night with the HSAT followed by LPSG on the second night. The SHOOTS questionnaire, composed of 6 questions (snoring, hyperactivity, obesity, observed apnea, tonsillar hypertrophy, and sleepiness) concerning sleep-disordered breathing, was administered by the clinician before the first study night.

RESULTS

Thirty-eight participants completed both studies. The mean age was 13.8 ± 3.0 years. Twenty (53%) were male. Most participants were obese. The mean LPSG total sleep time was 7.34 ± 1.19 hours; the mean HSAT total recording time was 8.86 ± 1.73 hours ( < .001). The median obstructive apnea-hypopnea index for LPSG and HSAT was 6.6 and 0.8 events/h, respectively. For an obstructive apnea-hypopnea index ≥ 3.1 events/h by HSAT, the sensitivity was 71.43% (95% confidence interval, 41.9-91.6) and the specificity was 95.83% (95% confidence interval, 78.9-99.9) for identifying those with an LPSG obstructive apnea-hypopnea index of ≥ 10 events/h. For a SHOOTS score with ≥ 4 "yes" responses, the sensitivity and specificity were 85.7% (95% confidence interval, 57.2-98.2) and 54.2% (95% confidence interval, 32.8-74.4), respectively, for identifying those with an LPSG obstructive apnea-hypopnea index ≥ 10 events/h.

CONCLUSIONS

Using HSAT, we clinically applied cutoff values to identify moderate to severe obstructive sleep apnea in typically developing children. The SHOOTS questionnaire may aid in identifying children at risk for obstructive sleep apnea and who are candidates for HSAT.

CITATION

Revana A, Vecchio J, Guffey D, Minard CG, Glaze DG. Clinical application of home sleep apnea testing in children: a prospective pilot study. 2022;18(2):533-540.

摘要

研究目的

（1）确定在通过过夜 attended 实验室多导睡眠图（LPSG）诊断为中重度阻塞性睡眠呼吸暂停的典型发育儿童中进行的家庭睡眠呼吸暂停测试（HSAT）的敏感性和特异性。（2）确定筛查问卷在识别阻塞性睡眠呼吸暂停风险增加的儿童方面的效用。

方法

参与者连续完成 2 个研究夜，第一个研究夜进行 HSAT，第二个研究夜进行 LPSG。SHOOTS 问卷由 6 个问题（打鼾、多动、肥胖、观察到的呼吸暂停、扁桃体肥大和嗜睡）组成，涉及睡眠呼吸障碍，由临床医生在第一个研究夜之前进行管理。

结果

38 名参与者完成了两项研究。平均年龄为 13.8±3.0 岁。20 名（53%）为男性。大多数参与者肥胖。LPSG 总睡眠时间的平均值为 7.34±1.19 小时；HSAT 总记录时间的平均值为 8.86±1.73 小时（<.001）。LPSG 和 HSAT 的中位阻塞性呼吸暂停低通气指数分别为 6.6 和 0.8 事件/小时。对于 HSAT 中阻塞性呼吸暂停低通气指数≥3.1 事件/小时，敏感性为 71.43%（95%置信区间，41.9-91.6），特异性为 95.83%（95%置信区间，78.9-99.9），用于识别那些 LPSG 中阻塞性呼吸暂停低通气指数≥10 事件/小时的患者。对于 SHOOTS 评分≥4“是”的情况，敏感性和特异性分别为 85.7%（95%置信区间，57.2-98.2）和 54.2%（95%置信区间，32.8-74.4），用于识别那些 LPSG 中阻塞性呼吸暂停低通气指数≥10 事件/小时的患者。