Katz Sherri L, Barwell Taylor, Bijelić Vid, Barrowman Nicholas, Blinder Henrietta, Dussah Naomi, Shamsi Roya, Leitman Alexa R, Ersu Refika
Department of Pediatrics, Division of Respirology, Children's Hospital of Eastern Ontario, Ontario, Ottawa, Canada.
Children's Hospital of Eastern Ontario Research Institute, Ontario, Ottawa, Canada.
Pediatr Pulmonol. 2025 Aug;60(8):e71228. doi: 10.1002/ppul.71228.
Diagnosing obstructive sleep apnea (OSA) in children is challenging, with long wait times for polysomnography (PSG). This study assessed the diagnostic accuracy of home-recorded video clips for OSA compared to PSG.
Children (2-18 years) referred for PSG for suspected OSA were enrolled. Parents recorded video clips of their child sleeping and completed the Pediatric Sleep Questionnaire (PSQ). Blinded clinicians scored videos using the Monash Obstructive Sleep Apnea score (MS). Participants underwent PSG, and outcomes included obstructive apnea-hypopnea index (OAHI) and oximetry metrics (i.e., McGill Oximetry Score [MOS]; 3% Oxygen Desaturation Index [ODI3]). Diagnostic characteristics of MS, PSQ, MOS, and ODI3 were compared for detection of any (OAHI ≥ 1.5 events/h) and moderate-severe OSA (OAHI ≥ 5 events/h).
Forty-one children (age 7.0 years, 49% female) participated. Median OAHI was 0.6 events/h (IQR 0.3, 3.1); 16 (39%) had OAHI ≥ 1.5 events/h, 5 (12%) had OAHI ≥ 5 events/h. PSQ identified 36 (88%) participants with a score ≥ 0.33. One child had MOS ≥ 2; ODI3 was ≥ 4.3 in 8 (20%) and > 7 in 6 (15%). Mean MS was 3.6 (SD 2.1). MS had 81.2% sensitivity and 52.0% specificity for any OSA and 100% sensitivity and 44.4% specificity for moderate-severe OSA. A combination of MS and ODI3 improved diagnostic accuracy with an AUC of 98.3.
MS demonstrated high sensitivity but low specificity for the detection of moderate-severe OSA. Video scores outperformed PSQ but were less accurate than oximetry. Combining MS and ODI3 yielded the strongest diagnostic characteristics. Video scores may aid in pediatric OSA screening.
诊断儿童阻塞性睡眠呼吸暂停（OSA）具有挑战性，多导睡眠图（PSG）的等待时间很长。本研究评估了与PSG相比，家庭录制视频片段对OSA的诊断准确性。
纳入因疑似OSA而被转诊进行PSG检查的儿童（2至18岁）。家长录制孩子睡眠的视频片段，并完成儿童睡眠问卷（PSQ）。不知情的临床医生使用莫纳什阻塞性睡眠呼吸暂停评分（MS）对视频进行评分。参与者接受PSG检查，结果包括阻塞性呼吸暂停低通气指数（OAHI）和血氧饱和度测量指标（即麦吉尔血氧饱和度评分[MOS]；3%氧饱和度下降指数[ODI3]）。比较MS、PSQ、MOS和ODI3对任何程度（OAHI≥1.5次/小时）和中重度OSA（OAHI≥5次/小时）的诊断特征。
41名儿童（年龄7.0岁，49%为女性）参与研究。OAHI中位数为0.6次/小时（四分位间距0.3，3.1）；16名（39%）儿童OAHI≥1.5次/小时，5名（12%）儿童OAHI≥5次/小时。PSQ识别出36名（88%）得分≥0.33的参与者。1名儿童MOS≥2；8名（20%）儿童ODI3≥4.3，6名（15%）儿童ODI3>7。MS的平均得分为3.6（标准差2.1）。MS对任何程度OSA的敏感性为81.2%，特异性为52.0%；对中重度OSA的敏感性为100%，特异性为44.4%。MS和ODI3联合使用可提高诊断准确性，曲线下面积为98.3。
MS对中重度OSA的检测具有高敏感性但低特异性。视频评分优于PSQ，但不如血氧饱和度测量准确。MS和ODI3联合使用具有最强的诊断特征。视频评分可能有助于儿童OSA的筛查。
