Marechal Manon, Renard Emeline, Franco Patricia, Mota Sofia Da, Schweitzer Noémie, Tiotiu Angelica, Schweitzer Cyril, Coutier Laurianne, Ioan Iulia
Service de Médecine Infantile, Centre Hospitalier Universitaire de Nancy, Nancy, France.
Service Epilepsie, Sommeil, Explorations Fonctionnelles Neurologiques Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Sommeil, Bron, France.
Eur Arch Otorhinolaryngol. 2025 Mar;282(3):1493-1500. doi: 10.1007/s00405-024-09143-5. Epub 2024 Dec 14.
Oximetry was proposed as an abbreviated exam, easily accepted by the child, for the diagnosis of obstructive sleep apnea (OSA) for children located in regions where access to pediatric sleep labs is limited. The objective of this study was to determine the diagnostic value of the oxygen desaturation index (ODI), the number of ≥ 3% oxygen desaturations per hour of recording, obtained by portable oximetry performed in parallel with video-polysomnography (PSG), in a cohort of children, with and without comorbidities, referred for OSA.
Data from portable oximetry performed in parallel with PSG were prospectively collected. The diagnostic value, sensitivity, and specificity of ODI to identify a moderate/severe OSA were computed.
81 children aged 3 to 18 years were included, 56 (69%) with comorbidities, 50 (62%) with moderate/severe OSA. The area under the ROC curves was 0.92 for ODI by PSG, 0.86 for ODI by PSG's oximetry and 0.78 for ODI by portable oximetry, to diagnose a moderate/severe OSA. All ODIs presented high specificity (1.0 for PSG, 0.90 for PSG's oximetry, 0.87 for portable oximetry) and moderate sensitivity (0.84 for PSG, 0.72 for PSG's oximetry, 0.60 for portable oximetry).
In children referred for OSA, particularly in those with a pre-existing comorbidity, ODI obtained by an abbreviated method had high specificity for the diagnosis of moderate/severe OSA and might be used to prioritize the access to a comprehensive sleep recording. Its low sensitivity suggests that a comprehensive sleep exam must be performed in case of a negative test.
在儿科睡眠实验室资源有限的地区，脉搏血氧测定法被提议作为一种简化检查方法，易于被儿童接受，用于诊断儿童阻塞性睡眠呼吸暂停（OSA）。本研究的目的是确定在一组因OSA就诊的儿童中，通过与视频多导睡眠图（PSG）同步进行的便携式脉搏血氧测定法获得的氧饱和度下降指数（ODI）（每小时记录中≥3%氧饱和度下降的次数）的诊断价值，这些儿童有或无合并症。
前瞻性收集与PSG同步进行的便携式脉搏血氧测定法的数据。计算ODI对识别中度/重度OSA的诊断价值、敏感性和特异性。
纳入81名3至18岁儿童，56名（69%）有合并症，50名（62%）患有中度/重度OSA。PSG的ODI诊断中度/重度OSA的ROC曲线下面积为0.92，PSG血氧测定法的ODI为0.86，便携式脉搏血氧测定法的ODI为0.78。所有ODI均表现出高特异性（PSG为1.0，PSG血氧测定法为0.90，便携式脉搏血氧测定法为0.87）和中度敏感性（PSG为0.84，PSG血氧测定法为0.72，便携式脉搏血氧测定法为0.60）。
在因OSA就诊的儿童中，特别是那些已有合并症的儿童，通过简化方法获得的ODI对中度/重度OSA的诊断具有高特异性，可用于优先安排全面睡眠记录检查。其低敏感性表明，检测结果为阴性时必须进行全面的睡眠检查。
