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Medline ® Abstract for Reference 86

of 'Evaluation of suspected obstructive sleep apnea in children'

86
TI
Respiratory monitoring by means of an unattended device in children with suspected uncomplicated obstructive sleep apnea: a validation study.
AU
Zucconi M, Calori G, Castronovo V, Ferini-Strambi L
SO
Chest. 2003 Aug;124(2):602-7.
 
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 PSGRDI>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.
AD
Sleep Disorders Center, Department of Neurology, and Statistic Unit, IRCCS H San Raffaele, Milan, Italy. zucconi.marco@hsr.it
PMID