Introduction
Sleep-related breathing disorders, or sleep-disordered breathing (SDB),
cover a range of conditions including obstructive sleep apnea (OSA),
central sleep apnea (CSA), sleep-related hypoventilation disorders, and
sleep-related hypoxemia disorder1. The most common
type of SDB, OSA, has a prevalence of 1-4% among children, although a
large variation between 0.1 and 13% exists due to varying diagnostic
criteria2. With OSA being only one type of SDB, total
SDB prevalence must be higher.
Overnight polysomnography (PSG) is considered the gold standard for
diagnosing sleep-disordered breathing (SDB) in
children3. However, PSG poses challenges as it is
expensive, time-consuming4, and can be particularly
challenging in
children5. In addition, the “first night effect” is
a well-known pitfall of studying breathing disorders using
PSG6. Pediatric SDB is typically known to be
underdiagnosed7. This underdiagnosis could partly be
due to the aforementioned problems in performing a PSG at a young age.
This highlights the demand for prompt, easy and reliable diagnosis using
safe, non-contact methods for respiration monitoring in a home setting.
To address the limitations of PSG, various monitoring systems, including
actigraphy and oximetry, have been proposed. However, the widespread use
of these systems is often hindered by the need for wiring sensors to the
body. An easy-to-set-up noncontact system for home monitoring would
allow more accessible respiration monitoring and would overcome the
challenges of attaching wearables or wiring to the child. Safe,
easy-to-use systems could be used for different purposes, including
screening for SDB, long-term monitoring and treatment evaluation.
Past reviews have focused on home-based, but not specifically
unobtrusive, respiration monitoring (e.g. Bertoni and
Isaiah8), or have focused solely on measuring
respiratory rate (RR) in neonates9. To our knowledge,
no reviews have been conducted to identify contactless methods for
respiration monitoring during sleep in young children.
The aim of this scoping review is threefold: (1) to provide an overview
of the studies reporting on safe noncontact monitoring of respiration in
young children; (2) to describe the accuracy of the techniques, and (3)
to highlight the advantages and limitations of each technique.