Ersu Refika, Shamsi Roya, Bjelic Vid, Barrowman Nicholas, Blinder Henrietta, Dussah Naomi, Cox Gianna, Leitman Alexa Rose, Katz Sherri Lynne
Division of Respirology, Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Sleep Med. 2025 Aug;132:106559. doi: 10.1016/j.sleep.2025.106559. Epub 2025 May 9.
Obstructive sleep apnea (OSA) significantly impacts children's health, but diagnosing OSA is challenging, especially during the COVID-19 pandemic with limited access to polysomnography (PSG). A recent study used 1-2-min sleep videos to assess OSA, developing the Monash score, which demonstrated 100 % sensitivity and 36 % specificity for moderate to severe OSA diagnosis with a score of 3 or higher.
We hypothesized that home video recordings using mobile technology could help clinicians identify children at risk of moderate to severe OSA.
This study included children 3-18 years referred for OSA evaluation. Parents recorded 3-min sleep videos over three nights. Sleep physicians, blinded to polygraphy (PG) results scored videos using the Monash score. PG with the Nox T3 device served as the reference standard, measuring airflow, respiratory patterns, and oxygen saturation. OSA was defined as mild-to-severe with obstructive apnea hypopnea index (oAHI) ≥1.5 events/hour, moderate-to-severe with oAHI ≥5, and severe with oAHI >10. Oximetry metrics (oxygen desaturation index 3 % (ODI3) ≥4.3 or >7, and McGill Oximetry Score (MOS) ≥2) indicated OSA presence.
Among 51 children (45 % female) included in the study, the Monash score showed 91.7 % sensitivity and 70.4 % specificity for mild-to-severe OSA, and 100 % sensitivity with 29.6 % specificity for moderate-to-severe OSA. ODI ≥4.3 had the highest diagnostic accuracy (AUC 98.5, 95 %CI 96-100), while the Monash score had an AUC of 84.5 (95 %CI 73.1-96.3).
Home-recorded videos offer high sensitivity for pediatric OSA screening and could prioritize at-risk children in resource-limited settings, enabling earlier diagnosis and intervention.
阻塞性睡眠呼吸暂停（OSA）对儿童健康有重大影响，但诊断OSA具有挑战性，尤其是在2019冠状病毒病大流行期间，多导睡眠图（PSG）检查受限。最近一项研究使用1至2分钟的睡眠视频评估OSA，制定了莫纳什评分，该评分对中度至重度OSA诊断（评分3分及以上）的敏感性为100%，特异性为36%。
我们假设使用移动技术进行家庭视频记录可以帮助临床医生识别有中度至重度OSA风险的儿童。
本研究纳入了因OSA评估而转诊的3至18岁儿童。家长在三个晚上录制3分钟的睡眠视频。睡眠科医生在不知道多导睡眠监测（PG）结果的情况下，使用莫纳什评分对视频进行评分。使用Nox T3设备进行的PG作为参考标准，测量气流、呼吸模式和血氧饱和度。OSA定义为轻度至重度，阻塞性呼吸暂停低通气指数（oAHI）≥1.5次/小时；中度至重度，oAHI≥5次/小时；重度，oAHI>10次/小时。血氧饱和度测量指标（氧饱和度下降指数3%（ODI3）≥4.3或>7，以及麦吉尔血氧饱和度评分（MOS）≥2）表明存在OSA。
在纳入研究的51名儿童（45%为女性）中，莫纳什评分对轻度至重度OSA的敏感性为91.7%，特异性为70.4%；对中度至重度OSA敏感性为100%，特异性为29.6%。ODI≥4.3的诊断准确性最高（曲线下面积98.5，95%置信区间96-100），而莫纳什评分的曲线下面积为84.5（95%置信区间73.1-96.3）。
家庭录制的视频对儿科OSA筛查具有高敏感性，并且可以在资源有限的环境中对有风险的儿童进行优先排序，从而实现早期诊断和干预。
