Diagnosis of pediatric obstructive sleep apnea hypopnea syndrome using a risk score based on polysomnography sleep video recordings: a pilot study
Saroul Nicolas1, Jens Erik Petersen1, Céline Lambert2, Mathilde Puechmaille1, Laurent Gilain1, Thierry Mom1, Yves Dauvilliers3, Maria Livia Fantini4, Patricia Beudin4, Mohamed Akkari5*.
1: Department of Otolaryngology- Head and neck surgery, CHU Clermont-Ferrand, Clermont-Ferrand, France
2: Biostatistics unit, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France
3: Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac University Hospital of Montpellier, University of Montpellier, Montpellier, France
4: Neurology Department, CHU Clermont-Ferrand, France
5: Department of Otolaryngology- Head and neck surgery, Gui de Chauliac University Hospital of Montpellier, Montpellier, France
*Corresponding author:
Corresponding Author:
Mohamed Akkari, M.D.
Department of ENT and Head and Neck Surgery
University Hospital Gui de Chauliac, 80 avenue Augustin Fliche 34295 Montpellier Cedex 5 France
Tel: +33 4 67 33 53 92
Fax: +33 4 67 33 67 28
m-akkari@chu-montpellier.fr
ORCID ID: 0000-0003-2408-4133
Key words: pediatric obstructive sleep apnea hypopnea syndrome, pediatric sleep disordered breathing, sleep video recording, polysomnography.
Funding: none
Conflict of interest: none
Nicolas Saroul: designed the research, conducted the research, wrote the paper, had the primary responsibility for the final content, read and approved the final manuscript. nsaroul@chu-clermontferrand.fr
Jens Erik Petersen: designed the research, conducted the research, wrote the paper, read and approved the final manuscript. jepetersen@chu-clermontferrand.fr
Céline Lambert: performed the statistical analysis, wrote the paper, read and approved the final manuscript. clambert@chu-clermontferrand.fr
Mathilde Puechmaille: designed the research, conducted the research, read and approved the final manuscript. mpuechmaille@chu-clermontferrand.fr
Laurent Gilain: designed the research, conducted the research, read and approved the final manuscript.l-gilain@chu-clermontferrand.fr
Thierry Mom: designed the research, conducted the research, read and approved the final manuscript.t-mom@chu-clermontferrand.fr
Yves Dauvilliers: designed the research, read and approved the final manuscript. y-dauvilliers@chu-montpellier.fr
Maria Livia Fantini: conducted the research, read and approved the final manuscript. mfantini@chu-clermontferrand.fr
Patricia Beudin: conducted the research, read and approved the final manuscript. pbeudin@chu-clermontferrand.fr
Mohamed Akkari: designed the research, wrote the paper, read and approved the final manuscript.m-akkari@chu-montpellier.fr
Abstract
Objectives: Because access to sleep recordings is limited, there is a need for new reliable diagnostic tools for pediatric obstructive sleep apnea-hypopnea syndrome (OSAHS) diagnosis. A score calculated from a 30 minutes-home sleep videotape recording has already been proposed in 1996 with interesting results. The main objective of this pilot study was to assess the reliability of a similar score applied to reference PSG video recordings and calculated on two different time windows (30 and 10 minutes).
Methods: Sixteen children suspected of OSAHS, aged between two and ten years, underwent video recording during overnight PSG. Video analysis was made during the second complete sleep cycle. A 30-minute risk score (RS30) and a 10-minute risk score (RS10) were established by analyzing seven parameters. The RS30 and RS10 were correlated with clinical examination data, a sleep questionnaire, the obstructive-apnea-hypopnea index (OAHI) and the oxygen desaturation index (ODI) from synchronized PSG results.
Results: There was a significant correlation between both the RS30 and RS10, the OAHI and ODI. A RS30 ≥ 6.09 was predictive of an OAHI ≥ 5 per hour with a sensitivity of 83% and a specificity of 90%. A RS10 ≥ 6.50 was predictive of an OAHI ≥ 5 per hour with a sensitivity of 67% and a specificity of 100%.
Conclusion: A risk score based on PSG video recordings shows a good correlation with PSG results, confirming previous reports. Further work should focus on applying this risk score to home sleep video recordings for the diagnosis of pediatric OSAHS.