Division of Otolaryngology-Head and Neck Surgery, University of Montreal, Montreal, QC, Canada.
Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, QC, Canada.
Sleep Med Rev. 2024 Dec;78:101991. doi: 10.1016/j.smrv.2024.101991. Epub 2024 Aug 8.
In recent years, a plethora of new type III and IV portable sleep monitors (PSM) have been developed, although evidence regarding their diagnostic accuracy for use in children remains heterogeneous. This study systematically reviews the literature addressing the diagnostic accuracies of type III and IV PSM for pediatric sleep apnea. Publications indexed in Medline, Embase, or Web of Science were reviewed using the PRISMA framework. Of 1054 studies, 62 fulfilled the inclusion criteria. Of the studies evaluating oximetry-based type IV PSM, one (6.25 %) demonstrated a balanced set of high (≥80 %) sensitivities and specificities for the diagnosis of any pediatric sleep apnea, while five studies (27.8 %) showed similar accuracies for moderate-to-severe sleep apnea. For non-oximetry-based type IV PSM, two studies (40 %) reported a balanced set of high diagnostic accuracies for moderate-to-severe sleep apnea. Type III PSM repeatedly demonstrated higher diagnostic accuracies, with six studies (66.7 %) reporting a balanced set of high diagnostic accuracies for moderate-to-severe sleep apnea. This review highlights the potential of type III PSM to detect moderate-to-severe pediatric sleep apnea, although current evidence is limited to support the stand-alone use of type IV PSM for the diagnosis of sleep apnea in most children.
近年来，已经开发出了许多新型 III 类和 IV 类便携式睡眠监测仪（PSM），尽管关于它们在儿童中使用的诊断准确性的证据仍然存在异质性。本研究系统地回顾了评估 III 类和 IV 类 PSM 用于儿童睡眠呼吸暂停的诊断准确性的文献。使用 PRISMA 框架审查了在 Medline、Embase 或 Web of Science 中索引的出版物。在 1054 项研究中，有 62 项符合纳入标准。在评估基于血氧饱和度的 IV 类 PSM 的研究中，一项（6.25%）研究表明，对于任何儿童睡眠呼吸暂停的诊断，具有较高（≥80%）灵敏度和特异性的平衡集，而五项研究（27.8%）显示出类似的中重度睡眠呼吸暂停的准确性。对于非基于血氧饱和度的 IV 类 PSM，两项研究（40%）报告了中重度睡眠呼吸暂停的高诊断准确性的平衡集。III 类 PSM 反复显示出较高的诊断准确性，其中六项研究（66.7%）报告了中重度睡眠呼吸暂停的高诊断准确性的平衡集。本综述强调了 III 类 PSM 检测中重度儿童睡眠呼吸暂停的潜力，尽管目前的证据仅限于支持在大多数儿童中单独使用 IV 类 PSM 来诊断睡眠呼吸暂停。
