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(Chest. 2003;124:1702-1708.)
© 2003 American College of Chest Physicians

Comparison of Home Oximetry Monitoring With Laboratory Polysomnography in Children*

Valerie G. Kirk, MD, FCCP; Shelly G. Bohn, BSc; W. Ward Flemons, MD and John E. Remmers, MD

* From the Departments of Pediatrics (Dr. Kirk and Ms. Bohn) and Medicine (Drs. Flemons and Remmers), University of Calgary, Calgary, AB, Canada.

Correspondence to: Valerie Kirk, MD, FCCP, 1820 Richmond Rd, SW Calgary, AB Canada T2T 5C7; e-mail: val.kirk{at}calgaryhealthregion.ca

Study objectives: To measure the accuracy and reliability of a portable home oximetry monitor with an automated analysis for the diagnosis of obstructive sleep apnea (OSA) in children.

Design: Prospective cohort study.

Setting: Alberta Lung Association Sleep Center, Alberta Children’s Hospital Sleep Clinic.

Study subjects: Consecutive, otherwise healthy children, aged 4 to 18 years, presenting to the Pediatric Sleep Service at the Alberta Children’s Hospital for assessment of possible OSA.

Interventions: All subjects underwent 2 nights of monitoring in the home with an oximetry-based portable monitor with an automatic internal scoring algorithm. A third night of monitoring was done simultaneously with computerized laboratory polysomnography according to American Thoracic Society guidelines.

Measurements and results: Both test-retest reliability of the portable monitor-based desaturation index (DI) between 2 nights at home and between laboratory and home were high using the Bland and Altman analysis (mean agreement, 0.32 and 0.64; limits of agreement, - 8.00 to 8.64 and - 0.75 to 6.50, respectively). The polysomnographic apnea-hypopnea index (AHI) agreed poorly with the portable monitor DI (mean difference, 1.27; limits of agreement, - 12.02 to 15.02). The sensitivity and specificity of the monitor for the identification of moderate sleep apnea (polysomnography AHI > 5/h) were 67% and 60%, respectively.

Conclusion: Portable monitoring based only on oximetry alone is not adequate for the identification of OSA in otherwise healthy children.

Key Words: abbreviated monitoring • ambulatory monitoring • children • diagnosis • obstructive sleep apnea • oximetry • sleep apnea syndromes




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Variations in Physician Interpretation of Overnight Pulse Oximetry Monitoring
Chest, September 1, 2007; 132(3): 852 - 859.
[Abstract] [Full Text] [PDF]


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