Respiratory monitoring by means of an unattended device in children with suspected uncomplicated obstructive sleep apnea: A validation study

Research output: Contribution to journalArticle

Abstract

Study objective: To compare an unattended device for cardiorespiratory monitoring (POLY-MESAM; MAP; Martinsried, Germany) [P-M] with classic nocturnal polysomnography (PSG) for diagnosis of obstructive sleep apnea (OSA) in children. Design: Clinical setting. Patients: Twelve children (age range, 3 to 6 years) with highly suspected uncomplicated OSA who underwent PSG and P-M on 2 consecutive laboratory nights in a balanced manner. Measurements: Respiratory indexes were compared for P-M (automated analysis), hand-scored revised P-M (P-Mrev), and PSG. Analysis of contingency for cutoff levels of respiratory disturbance index (RDI) of 5 and 10 and level of agreement between P-M, P-Mrev, and PSG by the concordance method were evaluated. Results: Nine of twelve children (75%) had a PSG RDI > 5, while 41.7% had an RDI > 10, indicating moderate-to-severe OSA. P-M sensitivity (78%) increased with the increase of the RDI cutoff, and P-Mrev sensitivity reached 100% at the cutoff of 10. The specificity was low for RDI > 5 and increased only modestly at RDI > 10 (P-Mrev, 57%). Seven of 12 children (increasing to 9 children with P-Mrev) and 9 of 12 children (increasing to 11 children with P-Mrev) were correctly classified by the P-M unit when cutoffs of 5 and 10 were considered, respectively. As far as the agreement level is concerned, P-M underestimated the incidence of obstructive hypopnea and overestimated the number of central apnea cases. P-Mrev improved the latter measure. Conclusion: Based on these data, the P-M device cannot be advocated for common use in a clinical setting, but it may have a role in urgent screening for highly suspected moderate-to-severe OSA.

Original languageEnglish
Pages (from-to)602-607
Number of pages6
JournalChest
Volume124
Issue number2
DOIs
Publication statusPublished - Aug 1 2003

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Validation Studies
Obstructive Sleep Apnea
Polysomnography
Equipment and Supplies
Central Sleep Apnea
Germany
Hand
Incidence

Keywords

  • Childhood obstructive sleep apnea
  • Nocturnal polysomnography
  • Respiratory monitoring
  • Unattended device
  • Validation study

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

@article{a17a9cd086394eb3833aff88d03b1acc,
title = "Respiratory monitoring by means of an unattended device in children with suspected uncomplicated obstructive sleep apnea: A validation study",
abstract = "Study objective: To compare an unattended device for cardiorespiratory monitoring (POLY-MESAM; MAP; Martinsried, Germany) [P-M] with classic nocturnal polysomnography (PSG) for diagnosis of obstructive sleep apnea (OSA) in children. Design: Clinical setting. Patients: Twelve children (age range, 3 to 6 years) with highly suspected uncomplicated OSA who underwent PSG and P-M on 2 consecutive laboratory nights in a balanced manner. Measurements: Respiratory indexes were compared for P-M (automated analysis), hand-scored revised P-M (P-Mrev), and PSG. Analysis of contingency for cutoff levels of respiratory disturbance index (RDI) of 5 and 10 and level of agreement between P-M, P-Mrev, and PSG by the concordance method were evaluated. Results: Nine of twelve children (75{\%}) had a PSG RDI > 5, while 41.7{\%} had an RDI > 10, indicating moderate-to-severe OSA. P-M sensitivity (78{\%}) increased with the increase of the RDI cutoff, and P-Mrev sensitivity reached 100{\%} at the cutoff of 10. The specificity was low for RDI > 5 and increased only modestly at RDI > 10 (P-Mrev, 57{\%}). Seven of 12 children (increasing to 9 children with P-Mrev) and 9 of 12 children (increasing to 11 children with P-Mrev) were correctly classified by the P-M unit when cutoffs of 5 and 10 were considered, respectively. As far as the agreement level is concerned, P-M underestimated the incidence of obstructive hypopnea and overestimated the number of central apnea cases. P-Mrev improved the latter measure. Conclusion: Based on these data, the P-M device cannot be advocated for common use in a clinical setting, but it may have a role in urgent screening for highly suspected moderate-to-severe OSA.",
keywords = "Childhood obstructive sleep apnea, Nocturnal polysomnography, Respiratory monitoring, Unattended device, Validation study",
author = "Marco Zucconi and Giliola Calori and Vincenza Castronovo and Luigi Ferini-Strambi",
year = "2003",
month = "8",
day = "1",
doi = "10.1378/chest.124.2.602",
language = "English",
volume = "124",
pages = "602--607",
journal = "Chest",
issn = "0012-3692",
publisher = "Elsevier Inc.",
number = "2",

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TY - JOUR

T1 - Respiratory monitoring by means of an unattended device in children with suspected uncomplicated obstructive sleep apnea

T2 - A validation study

AU - Zucconi, Marco

AU - Calori, Giliola

AU - Castronovo, Vincenza

AU - Ferini-Strambi, Luigi

PY - 2003/8/1

Y1 - 2003/8/1

N2 - Study objective: To compare an unattended device for cardiorespiratory monitoring (POLY-MESAM; MAP; Martinsried, Germany) [P-M] with classic nocturnal polysomnography (PSG) for diagnosis of obstructive sleep apnea (OSA) in children. Design: Clinical setting. Patients: Twelve children (age range, 3 to 6 years) with highly suspected uncomplicated OSA who underwent PSG and P-M on 2 consecutive laboratory nights in a balanced manner. Measurements: Respiratory indexes were compared for P-M (automated analysis), hand-scored revised P-M (P-Mrev), and PSG. Analysis of contingency for cutoff levels of respiratory disturbance index (RDI) of 5 and 10 and level of agreement between P-M, P-Mrev, and PSG by the concordance method were evaluated. Results: Nine of twelve children (75%) had a PSG RDI > 5, while 41.7% had an RDI > 10, indicating moderate-to-severe OSA. P-M sensitivity (78%) increased with the increase of the RDI cutoff, and P-Mrev sensitivity reached 100% at the cutoff of 10. The specificity was low for RDI > 5 and increased only modestly at RDI > 10 (P-Mrev, 57%). Seven of 12 children (increasing to 9 children with P-Mrev) and 9 of 12 children (increasing to 11 children with P-Mrev) were correctly classified by the P-M unit when cutoffs of 5 and 10 were considered, respectively. As far as the agreement level is concerned, P-M underestimated the incidence of obstructive hypopnea and overestimated the number of central apnea cases. P-Mrev improved the latter measure. Conclusion: Based on these data, the P-M device cannot be advocated for common use in a clinical setting, but it may have a role in urgent screening for highly suspected moderate-to-severe OSA.

AB - Study objective: To compare an unattended device for cardiorespiratory monitoring (POLY-MESAM; MAP; Martinsried, Germany) [P-M] with classic nocturnal polysomnography (PSG) for diagnosis of obstructive sleep apnea (OSA) in children. Design: Clinical setting. Patients: Twelve children (age range, 3 to 6 years) with highly suspected uncomplicated OSA who underwent PSG and P-M on 2 consecutive laboratory nights in a balanced manner. Measurements: Respiratory indexes were compared for P-M (automated analysis), hand-scored revised P-M (P-Mrev), and PSG. Analysis of contingency for cutoff levels of respiratory disturbance index (RDI) of 5 and 10 and level of agreement between P-M, P-Mrev, and PSG by the concordance method were evaluated. Results: Nine of twelve children (75%) had a PSG RDI > 5, while 41.7% had an RDI > 10, indicating moderate-to-severe OSA. P-M sensitivity (78%) increased with the increase of the RDI cutoff, and P-Mrev sensitivity reached 100% at the cutoff of 10. The specificity was low for RDI > 5 and increased only modestly at RDI > 10 (P-Mrev, 57%). Seven of 12 children (increasing to 9 children with P-Mrev) and 9 of 12 children (increasing to 11 children with P-Mrev) were correctly classified by the P-M unit when cutoffs of 5 and 10 were considered, respectively. As far as the agreement level is concerned, P-M underestimated the incidence of obstructive hypopnea and overestimated the number of central apnea cases. P-Mrev improved the latter measure. Conclusion: Based on these data, the P-M device cannot be advocated for common use in a clinical setting, but it may have a role in urgent screening for highly suspected moderate-to-severe OSA.

KW - Childhood obstructive sleep apnea

KW - Nocturnal polysomnography

KW - Respiratory monitoring

KW - Unattended device

KW - Validation study

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