Utility of Overnight Oximetry Indices in the Evaluation of Children with Snoring and Suspected Obstructive Sleep Apnea

Overview

Journal J Clin Sleep Med

Specialties Neurology
Psychiatry

Date 2024 Sep 19

PMID 39297542

Authors

Yu Qian Koh

Rehena Sultana

Arun Pugalenthi

Yi Hua Tan

Ooh Hoe Teoh

Zai Ru Cheng

Duo-Tong Cheng

Oh Moh Chay

John Carson Allen

Soh Gin Tan

M Lim

Jasmine Tan

Biju Thomas

Affiliations

Soon will be listed here.

Abstract

Study Objectives: Optimal cutoff values of oximetry indices that differentiate obstructive sleep apnea (OSA) from primary snoring (PS) are not well-established. Our study aimed to assess the utility of overnight oximetry indices in differentiating PS from OSA and assessing OSA severity, compared to polysomnography, in children with suspected OSA.

Methods: This was a retrospective study of children (1-18 years of age) with snoring who underwent polysomnography. Patients with Down syndrome, craniofacial anomalies, known genetic syndromes, neuromuscular conditions, or a central apnea index ≥ 5 were excluded. Demographic data, polysomnography variables, and oximetry indices (eg, oxygen desaturation index [ODI, defined as number of ≥ 3% desaturation episodes/h of artifact-free recording time, and SpO nadir]) were collected.

Results: Of 1,203 children (mean age 9.1 ± 3.9 years, 67.7% males), 91.8% (847/923) ≤ 12 years and 84.3% (236/280) > 12 years of age had OSA. The optimal cutoff of ODI for differentiating PS from OSA was 2.4 (sensitivity [Se]: 78.8% [75.9-81.6%]; specificity [Sp]: 80.5% [69.9-88.7%]) in children ≤ 12 years of age and 3.6 (Se: 71.1% [64.8-76.8%]; Sp: 91.1% [78.8-97.5%]) in children > 12 years of age. The optimal cutoffs of ODI for differentiating PS from mild, moderate, and severe OSA categories were 2.0 (Se: 70.1% [65.3-74.5%]; Sp: 70.1% [58.6-80.0%]), 3.7 (Se: 82.3% [76.6-87.1%]; Sp: 94.8% [87.2-98.6%]), and 4.3 (Se: 99.1% [96.8-99.9%]; Sp: 98.7% [93.0-100.0%]) in children ≤ 12 years of age and 1.9 (Se: 78.8% [75.9-81.6%]; Sp: 80.5% [69.9-88.7%]), 4.1 (Se: 85.4% [72.2-93.9%]; Sp: 91.1% [78.8-97.5%]), and 6.9 (Se: 98.4% [91.2-100.0%]; Sp: 97.8% [88.2-99.9%]) in children > 12 years of age, respectively.

Conclusions: This study provides optimal cutoff values for ODI in differentiating PS from OSA and assessing OSA severity in children. Because oximetry is cheaper and widely available, ODI has the potential to be incorporated into cost-effective clinical decision-making algorithms, especially in resource-limited settings.

Citation: Koh YQ, Sultana R, Pugalenthi A, et al. Utility of overnight oximetry indices in the evaluation of children with snoring and suspected obstructive sleep apnea. 2025;21(1):109-121.

Citing Articles

Progress in alternative diagnostic modalities for pediatric obstructive sleep apnea: a global need.

Sanchez-Solano N, Cielo C J Clin Sleep Med. 2024; 21(1):7-8.

PMID: 39484809 PMC: 11701281. DOI: 10.5664/jcsm.11464.

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