Sunday, April 19, 2015

Home test can diagnose sleep apnea in children

Of course this is interesting, but consider the importance of sleep studies in kids is not just to find evidence of sleep apnea. We need to identify those who have severe apnea to know who is at medical risk of complications from surgery.  

This is why the AAP recommends a sleep study BEFORE tonsillectomy.

Note that the agreement was higher in the lab for the same device. So..can you trust the results at home?

I dont like "probably" as an answer.

So, if its positive, a child needs a psg ...and..if its negative, the child needs a psg. 

Bottom line: kids are different than adults....JR

A respiratory polygraphy test that can be administered at home accurately diagnoses children with sleep apnea.

The use of home respiratory polygraphy to diagnose children with sleep apnea was reliable and comparable to the results of polysomnography and an in-laboratory respiratory polygraphy, according to study results.

‘This study shows that [home respiratory polygraphy (HRP)] provides a reasonably valid alternative to [in-laboratory polysomnography (PSG)] for the diagnosis of [obstructive sleep apnea-hypopnea syndrome (OSAS)] in children clinically referred with a high index of clinical suspicion for the presence of OSAS,” María Luz Alonso-Álvarez, MD, of the Hospital Universitario de Burgos in Spain, and colleagues wrote. “This frequent and highly prevalent pediatric condition is associated with adverse consequences and excessive and costly use of health care services.”
The researchers conducted a prospective, blinded study on 50 randomly selected children (mean age, 5.3 years) being evaluated for clinical suspicion of OSAS. Participants were given an HRP and within 2 weeks a simultaneousPSG and in-laboratory respiratory polygraphy (LRP).
Sixty-six percent of the children were diagnosed with OSAS based on a PSG-defined obstructive respiratory disturbance index (ORDI) of at least three events per hour during sleep.
Using the interclass correlation coefficient, ORDI agreement between PSG and LRP (ORDI = 96.5; 95% CI, 92.3-98.2) as well as HRP (ORDI = 86.7; 95% CI, 76.5-92.5) was greater than 80% in all cases but higher for LRP than HRP.
The researchers emphasized the importance and validity of using HRP in the diagnoses of children suspected of having OSAS, namely reduced cost and the comfort of home testing.
“We should stress, however, that when inconclusive HRP findings occur, a conventional PSG should be performed, and we further recommend incremental research efforts, particularly for the mild diagnosis of OSA using HRP in children,” the researchers wrote.
Read more here

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