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Pulse transit time and assessment of childhood sleep disordered breathing.

Abstract

OBJECTIVES
To compare nocturnal polysomnography (PSG) with pulse transit time (PTT) recordings and structured clinical assessments and assess the reliability of these methods as a surrogate for the apnea-hypopnea index (AHI; calculated as the number of apneas/hypopneas per hour of total sleep time) and to test the associations between the clinical assessments and sleep disordered breathing (SDB).
DESIGN
Prospective observational study. The parents of 51 children and adolescents filled out a questionnaire on SDB and the participants underwent examination. Scores from questionnaire and examination items were weighted according to their association with SDB. A total clinical score was assigned combining questionnaire and examination scores.
SETTING
Hospital pediatrics department.
PATIENTS
Children and adolescents aged 5 to 17 years undergoing standard PSG with the addition of PTT as part of a clinical investigation for SDB.
MAIN OUTCOME MEASURES
The AHI and associations between the AHI and PTT arousal index (PTT-AI) and questionnaire, examination, and total clinical scores.
RESULTS
We found a significant correlation between the AHI and PTT-AI (r = 0.55; P < .001). The relationship between the AHI and PTT-AI was stronger when the AHI was greater than 3. We also found significant correlations between the PTT-AI and the total clinical score (r = 0.38; P = .008) and the examination score (r = 0.44; P = .002) but not the questionnaire score (r = 0.23; P = .12). There was an association between the AHI and examination score in particular when the AHI was greater than 3.
CONCLUSIONS
Pulse transit time shows promise as a screening test for SDB associated with an AHI greater than 3. For less severe SDB, the validity of using the PTT to separate these conditions from primary snoring has not been demonstrated in a clinical setting.

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  • Publisher Full Text
  • Authors

    Bradley J, Galland BC, Bakker JP, Tan E, Gray A, Taylor BJ, Dawes PJ

    Source

    Archives of otolaryngology--head & neck surgery 138:4 2012 Apr pg 398-403

    MeSH

    Adolescent
    Area Under Curve
    Child
    Child, Preschool
    Electrocardiography
    Female
    Humans
    Logistic Models
    Male
    Observation
    Oximetry
    Physical Examination
    Polysomnography
    Prospective Studies
    Questionnaires
    ROC Curve
    Reproducibility of Results
    Sensitivity and Specificity
    Sleep Apnea Syndromes
    Software

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22508624