比较家庭多导睡眠图联合经皮二氧化碳监测与实验室多导睡眠图在神经肌肉疾病患儿中的应用。

Comparing home polysomnography with transcutaneous CO monitoring to laboratory polysomnography in children with neuromuscular disorders.

作者信息

Withers Adelaide, Pettigrew Grace, Filmer Kirrily, Lam Jenny, Downs Jenny, Wilson Andrew

机构信息

Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, Western Australia, Australia.

The Kids Research Institute Australia, Perth, Western Australia, Australia.

出版信息

J Clin Sleep Med. 2025 Apr 1;21(4):639-648. doi: 10.5664/jcsm.11490.

DOI:10.5664/jcsm.11490

PMID:39663926

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11965092/

Abstract

STUDY OBJECTIVES

Clinical utility of home polysomnography in children with neuromuscular disorders is limited by lack of evidence that sleep-disordered breathing can be reliably identified and inability to diagnose hypoventilation because carbon dioxide is not measured.

METHODS

This study aimed to determine the feasibility, accuracy, and parent satisfaction for home polysomnography performed with a type 2 portable monitoring device and a transcutaneous CO monitor. Results of laboratory and home polysomnography were compared with Mann-Whitney U tests and random intercept regression models.

RESULTS

Nineteen paired polysomnograms were performed for participants with various neuromuscular disorders at a median age of 9 years. Feasibility, defined as adequate data recorded from the portable monitoring device and transcutaneous CO monitor, was 68%. Adequate transcutaneous CO data were recorded in 89% of home studies. Significant differences were higher total sleep time, less awake time, and less N1 sleep during home polysomnography. Home polysomnography had a sensitivity of 50% for diagnosis of hypoventilation and 78% for obstructive sleep apnea. Home polysomnography underestimated severity of obstructive sleep apnea in 3 cases. Parent satisfaction for home polysomnography was high.

CONCLUSIONS

This is the first study to measure transcutaneous CO during type 2 home polysomnography in children with neuromuscular disorders. Results suggest better sleep quality at home during testing. Current sensitivity of home polysomnography for the diagnosis of sleep-disordered breathing is too low for clinical use; however, the feasibility of transcutaneous CO measurement in the home and high satisfaction justify further research to improve accuracy of home polysomnography in this population.

CITATION

Withers A, Pettigrew G, Filmer K, Lam J, Downs J, Wilson A. Comparing home polysomnography with transcutaneous CO monitoring to laboratory polysomnography in children with neuromuscular disorders. 2025;21(4):639-648.

摘要

研究目的

家庭多导睡眠图在患有神经肌肉疾病的儿童中的临床应用受到限制，原因是缺乏证据表明睡眠呼吸障碍能够被可靠识别，且由于未测量二氧化碳，无法诊断通气不足。

方法

本研究旨在确定使用2型便携式监测设备和经皮二氧化碳监测仪进行家庭多导睡眠图的可行性、准确性以及家长满意度。将实验室多导睡眠图和家庭多导睡眠图的结果进行曼-惠特尼U检验和随机截距回归模型分析。

结果

对19名患有各种神经肌肉疾病的参与者进行了配对多导睡眠图检查，中位年龄为9岁。可行性定义为从便携式监测设备和经皮二氧化碳监测仪记录到足够的数据，可行性为68%。在89%的家庭研究中记录到了足够的经皮二氧化碳数据。家庭多导睡眠图期间总睡眠时间更长、清醒时间更少、N1睡眠更少，存在显著差异。家庭多导睡眠图诊断通气不足的敏感性为50%，诊断阻塞性睡眠呼吸暂停的敏感性为78%。家庭多导睡眠图低估了3例阻塞性睡眠呼吸暂停的严重程度。家长对家庭多导睡眠图的满意度较高。