唐氏综合征青少年家庭睡眠呼吸暂停测试的可行性和性能。

Feasibility and performance of home sleep apnea testing in youth with Down syndrome.

机构信息

Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

出版信息

J Clin Sleep Med. 2023 Sep 1;19(9):1605-1613. doi: 10.5664/jcsm.10610.

DOI:10.5664/jcsm.10610

PMID:37185265

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10476042/

Abstract

STUDY OBJECTIVES

In-laboratory polysomnography is recommended for the evaluation of obstructive sleep apnea (OSA) in youth with Down syndrome. However, insufficient sleep laboratories are available, particularly for youth with neurocognitive disabilities such as Down syndrome. We hypothesized that level II home sleep apnea testing (HSAT) would be feasible, acceptable, and accurate in detecting polysomnography-defined moderate-severe OSA in youth with Down syndrome.

METHODS

Youth 6 to 25 years old with Down syndrome were recruited to undergo in-home level II HSAT with electroencephalogram and in-lab polysomnography. Parents completed questionnaires assessing feasibility, acceptability, and test preference. HSAT, scored blinded to polysomnography result, were compared to reference polysomnography.

RESULTS

Forty-three youth (23 female) aged [median (range)] 15.5 (6.1, 25.1) years participated in the study. Forty-one participants were able to complete HSAT and 41 completed polysomnography, with 40 who underwent both tests. HSAT was preferred to polysomnography by 73.7% of parents. Total sleep time for HSAT was 437 ± 123 minutes vs 366 ± 90 minutes for polysomnography ( = .003). Obstructive apnea-hypopnea index by polysomnography was 12.7 events/h (0.2, 113.8), and 32 youth (80%) who completed all testing had OSA. Compared to polysomnography, sensitivity of HSAT was: 0.81, specificity was 0.75, accuracy was 0.8 including 2 youth whose HSAT demonstrated OSA when polysomnography did not.

CONCLUSIONS

In youth with Down syndrome, level II HSAT was well-tolerated, preferred compared to in-lab polysomnography, and had good accuracy for detecting moderate-severe OSA. Level II HSAT could provide a means for expanding the evaluation of OSA in youth with Down syndrome.

CITATION

Cielo CM, Kelly A, Xanthopoulos M, et al. Feasibility and performance of home sleep apnea testing in youth with Down syndrome . 2023;19(9):1605-1613.

摘要

研究目的

对于唐氏综合征患者，建议在实验室中进行多导睡眠图检查以评估阻塞性睡眠呼吸暂停（OSA）。然而，睡眠实验室资源不足，尤其是对于唐氏综合征等存在神经认知障碍的青少年而言。我们假设，二级家庭睡眠呼吸暂停测试（HSAT）在检测唐氏综合征青少年的多导睡眠图定义的中重度 OSA 方面是可行的、可接受的和准确的。

方法

招募 6 至 25 岁的唐氏综合征青少年在家中进行二级 HSAT，包括脑电图和实验室多导睡眠图。父母完成了评估可行性、可接受性和测试偏好的问卷。对 HSAT 进行盲法评分，并与参考多导睡眠图进行比较。

结果

43 名青少年（23 名女性）参与了这项研究，年龄为[中位数（范围）]15.5（6.1，25.1）岁。41 名参与者能够完成 HSAT，41 名参与者能够完成多导睡眠图，其中 40 名参与者同时完成了这两项测试。73.7%的家长更喜欢 HSAT 而不是多导睡眠图。HSAT 的总睡眠时间为 437±123 分钟，而多导睡眠图为 366±90 分钟（ =.003）。多导睡眠图显示的阻塞性呼吸暂停低通气指数为 12.7 次/小时（0.2，113.8），40 名完成所有测试的青少年中有 32 人（80%）患有 OSA。与多导睡眠图相比，HSAT 的敏感性为 0.81，特异性为 0.75，准确性为 0.8，包括 2 名 HSAT 显示 OSA 而多导睡眠图未显示的青少年。