Observational study to define reference ranges for the 3% oxygen desaturation index during sleep in healthy children under 12 years using oximetry motion-resistant technology

2020 ◽  
pp. archdischild-2020-320066 ◽  
Author(s):  
Jonathan Wen Yi Ong ◽  
Daniel Williams ◽  
Johanna C Gavlak ◽  
Natasha Liddle ◽  
Paula Lowe ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Sleep Disordered Breathing ◽  
Oxygen Desaturation ◽  
Reference Ranges ◽  
Healthy Children ◽  
Mean Values ◽  
Desaturation Index ◽  
Oxygen Desaturation Index ◽  
The Mean ◽  
Pulse Oximeters

ObjectiveTo define reference ranges for the 3% oxygen desaturation index (DI3) in healthy children under 12 years old during sleep.DesignObservational.SettingHome.SubjectsHealthy children aged 6 months to 12 years of age.InterventionNocturnal pulse oximetry at home. Parents documented sleep times. Visi-Download software (Stowood Scientific) analysed data with artefact and wake periods removed.Main outcome measuresThe following oximetry parameters used in the assessment of sleep-disordered breathing conditions were measured: 3% (DI3) and 4% (DI4) oxygen desaturation indices—the number of times per hour where the oxygen saturation falls by at least 3% or 4% from baseline, mean saturations (SAT50), minimum saturations (SATmin), delta index 12 s (DI12s), and percentage time with saturations below 92% and 90%.ResultsSeventy-nine children underwent nocturnal home pulse oximetry, from which there were 66 studies suitable for analysis. The median values for DI3 and DI4 were 2.58 (95% CI 1.96 to 3.10) and 0.92 (95% CI 0.73 to 1.15), respectively. The 95th and 97.5th centiles for DI3 were 6.43 and 7.06, respectively, which inform our cut-off value for normality. The mean values for SAT50 and SATmin were 97.57% (95% CI 97.38% to 97.76%) and 91.09% (95% CI 90.32% to 91.86%), respectively.ConclusionIn children aged 6 months to 12 years, we define normality of the 3% oxygen desaturation index as <7 using standalone, motion-resistant pulse oximeters with short averaging times.

THE OXYGEN DESATURATION INDEX: A VALUABLE PARAMETER FROM NOCTURNAL PULSE OXIMETRY MONITORING

CHEST Journal ◽  
2007 ◽  
Vol 132 (4) ◽  
pp. 647B ◽  
Author(s):  
Fidaa Shaib ◽  
Jinesh Mehta ◽  
Yasmeen Shaw ◽  
Maria Cirino-Marcano ◽  
Ihab Hamzeh
Keyword(s):  
Pulse Oximetry ◽  
Oxygen Desaturation ◽  
Desaturation Index ◽  
Oxygen Desaturation Index

scholarly journals P064 The Impact of Artefact-free Recording Time on the Diagnosis of Sleep Disordered Breathing

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A42-A42
Author(s):  
A Knowles ◽  
M Stibalova ◽  
H Gajaweera ◽  
C Hill ◽  
H Evans
Keyword(s):  
Sleep Disordered Breathing ◽  
Operating Characteristic ◽  
Roc Curves ◽  
Oxygen Desaturation ◽  
Recording Time ◽  
Desaturation Index ◽  
Oxygen Desaturation Index ◽  
Central Apnoea ◽  
The Impact ◽  
Disordered Breathing

Abstract Background Overnight studies are used to diagnose sleep disordered breathing (SDB), however the minimum artefact-free recording time (AFRT) has not been established in children. Aim To determine the impact of AFRT on SDB diagnoses. Methods Patients attended overnight cardiorespiratory polygraphy/polysomnography, alongside pulse oximetry sleep studies. Respiratory parameter reports were generated using the first 4, 5, 6 and 7 hours of AFRT. Predetermined clinically relevant cut-off (CRCO) values were defined: Obstructive AHI (OAHI; CRCO≥2); Central Apnoea-Hypopnoea Index (CAHI; CRCO≥5); 3% Oxygen Desaturation Index (ODI3%; CRCO≥6); 4% Oxygen Desaturation Index (ODI4%; CRCO≥4). Studies crossing CRCO across different AFRTs were described as ‘Cases of Change’ (COC). Receiver operating characteristic (ROC) curves determined ranges at 4 hours which predicted COC across subsequent AFRTs. Results 137 children (0.39–17.98 years) were consecutively recruited. Mean OAHI, CAHI, ODI3% and ODI4% were 1.54 (σ=2.66), 1.56 (σ=3.43), 5.21 (σ=6.53) and 2.77 (σ=4.42) respectively. For children achieving 7 hours AFRT (n=103), COC from 4 hours were: OAHI≥2 =9.7% (10/103); CAHI≥5 =2.9% (3/103); ODI3%≥6 =3.7% (4/109); ODI4%≥4 =1.8% (2/109). For OAHI≥2, optimal points on ROC curves for predicting COC provided a range of 0.875 (AUC= 0.733; 50% sensitivity; 93% specificity) - 3.125 (AUC= 0.968; 100% sensitivity; 81% specificity). Conclusion Four hours AFRT yields diagnostic results in &gt; 90% cases when commonly used cut-off criteria are applied. For OSA, ranges at 4 hours within which diagnostic change is most likely with longer periods of AFRT are provided. Consideration should be given to repeating short studies where values lie within these ranges.

scholarly journals O041 The impact of including oxygen desaturations occurring during awake epochs on the oxygen desaturation index

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A17-A19
Author(s):  
C Whenn ◽  
D Wilson ◽  
T Churchward ◽  
W Ruehland ◽  
C Worsnop ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Sleep Disordered Breathing ◽  
Sleep Efficiency ◽  
Oxygen Desaturation ◽  
Desaturation Index ◽  
Oxygen Desaturation Index ◽  
Accepted Standard ◽  
The Impact ◽  
Larger Sample ◽  
Aasm Manual

Abstract Introduction The oxygen desaturation index (ODI) is an important measure of sleep disordered breathing during polysomnography (PSG) however there is no accepted standard for its calculation. The AASM Manual for the Scoring of Sleep and Associated events (V2.6) does not specify whether oxygen desaturations occurring during awake epochs should be included. More generally, epoch-based scoring is potentially problematic for accurate ODI calculation. This study aims to compare the calculation of ODI including and excluding oxygen desaturations occurring during awake epochs and to determine the impact of sleep efficiency (SE) on any discrepancy. Methods Using twenty-one consecutive unattended PSG’s for investigation of OSA, two oxygen desaturation indices were calculated from each PSG; one excluding (ODIsleep) and one including (ODIall) oxygen desaturations marked in awake epochs. Results The median (IQR) ODIall was 19.3/h (10.3, 27.0) and ODIsleep was 13.0/h (6.6, 16.7). The median (IQR) difference (ODIall - ODIsleep) was 5.2/h (2.7, 10.4). This difference was greater with decreasing SE (r = -.63, p = .002). Patients with SE ≤ 75% (n=10) had a median ODI difference of 11.5/h (4.0, 17.6), and those with SE &gt; 75% (n=11) had a difference of 2.8/h (2.0, 5.5) (p = .02). Discussion ODI was greater when including oxygen desaturations during awake epochs, with this discrepancy being greatest when SE is ≤ 75%. We plan to confirm these findings in a larger sample. This investigation informs clinical practice, highlights the difficulties of epoch scoring, and informs future standards for the scoring of sleep and associated events.

scholarly journals Diagnostic Accuracy of Oxygen Desaturation Index for Sleep-Disordered Breathing in Patients With Diabetes

2021 ◽  
Vol 12 ◽  
Author(s):  
Lihong Chen ◽  
Weiwei Tang ◽  
Chun Wang ◽  
Dawei Chen ◽  
Yun Gao ◽  
...  
Keyword(s):  
Sleep Disordered Breathing ◽  
Characteristic Curve ◽  
Sleep Time ◽  
Oxygen Desaturation ◽  
Apnea Hypopnea Index ◽  
Two Phase ◽  
Desaturation Index ◽  
Oxygen Desaturation Index ◽  
Patients With Diabetes ◽  
Disordered Breathing

BackgroundPolysomnography (PSG) is the gold standard for diagnosis of sleep-disordered breathing (SDB). But it is impractical to perform PSG in all patients with diabetes. The objective was to develop a clinically easy-to-use prediction model to diagnosis SDB in patients with diabetes.MethodsA total of 440 patients with diabetes were recruited and underwent overnight PSG at West China Hospital. Prediction algorithms were based on oxygen desaturation index (ODI) and other variables, including sex, age, body mass index, Epworth score, mean oxygen saturation, and total sleep time. Two phase approach was employed to derivate and validate the models.ResultsODI was strongly correlated with apnea-hypopnea index (AHI) (rs = 0.941). In the derivation phase, the single cutoff model with ODI was selected, with area under the receiver operating characteristic curve (AUC) of 0.956 (95%CI 0.917–0.994), 0.962 (95%CI 0.943–0.981), and 0.976 (95%CI 0.956–0.996) for predicting AHI ≥5/h, ≥15/h, and ≥30/h, respectively. We identified the cutoff of ODI 5/h, 15/h, and 25/h, as having important predictive value for AHI ≥5/h, ≥15/h, and ≥30/h, respectively. In the validation phase, the AUC of ODI was 0.941 (95%CI 0.904–0.978), 0.969 (95%CI 0.969–0.991), and 0.949 (95%CI 0.915–0.983) for predicting AHI ≥5/h, ≥15/h, and ≥30/h, respectively. The sensitivity of ODI ≥5/h, ≥15/h, and ≥25/h was 92%, 90%, and 93%, respectively, while the specificity was 73%, 89%, and 85%, respectively.ConclusionsODI is a sensitive and specific tool to predict SDB in patients with diabetes.

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