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. 2022 Feb 1;18(2):533-540.
doi: 10.5664/jcsm.9650.

Clinical application of home sleep apnea testing in children: a prospective pilot study

Amee Revana  1 , Jason Vecchio  1 , Danielle Guffey  1 , Charles G Minard  1 , Daniel G Glaze  1
Affiliations

Clinical application of home sleep apnea testing in children: a prospective pilot study

Amee Revana et al. J Clin Sleep Med. .

Abstract

Study objectives: (1) To determine the sensitivity and specificity of the home sleep apnea test (HSAT) performed in typically developing children who were diagnosed with moderate to severe obstructive sleep apnea during overnight attended laboratory polysomnography (LPSG). (2) To determine the utility of a screening questionnaire to identify children at increased risk for obstructive sleep apnea.

Methods: Participants completed 2 consecutive study nights, the first night with the HSAT followed by LPSG on the second night. The SHOOTS questionnaire, composed of 6 questions (snoring, hyperactivity, obesity, observed apnea, tonsillar hypertrophy, and sleepiness) concerning sleep-disordered breathing, was administered by the clinician before the first study night.

Results: Thirty-eight participants completed both studies. The mean age was 13.8 ± 3.0 years. Twenty (53%) were male. Most participants were obese. The mean LPSG total sleep time was 7.34 ± 1.19 hours; the mean HSAT total recording time was 8.86 ± 1.73 hours (P < .001). The median obstructive apnea-hypopnea index for LPSG and HSAT was 6.6 and 0.8 events/h, respectively. For an obstructive apnea-hypopnea index ≥ 3.1 events/h by HSAT, the sensitivity was 71.43% (95% confidence interval, 41.9-91.6) and the specificity was 95.83% (95% confidence interval, 78.9-99.9) for identifying those with an LPSG obstructive apnea-hypopnea index of ≥ 10 events/h. For a SHOOTS score with ≥ 4 "yes" responses, the sensitivity and specificity were 85.7% (95% confidence interval, 57.2-98.2) and 54.2% (95% confidence interval, 32.8-74.4), respectively, for identifying those with an LPSG obstructive apnea-hypopnea index ≥ 10 events/h.

Conclusions: Using HSAT, we clinically applied cutoff values to identify moderate to severe obstructive sleep apnea in typically developing children. The SHOOTS questionnaire may aid in identifying children at risk for obstructive sleep apnea and who are candidates for HSAT.

Citation: Revana A, Vecchio J, Guffey D, Minard CG, Glaze DG. Clinical application of home sleep apnea testing in children: a prospective pilot study. J Clin Sleep Med. 2022;18(2):533-540.

Keywords: HSAT; OSA; home sleep apnea test; obstructive sleep apnea; pediatrics.

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Conflict of interest statement

All authors on this manuscript have reviewed, edited, and approved the manuscript. Work for this study was performed at Texas Children’s Hospital, Houston, Texas/Baylor College of Medicine, Houston, Texas. The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Scatterplots.
Left: Scatterplot of oAHI for both LPSG and HSAT (regression coefficient = 4.20; 95% CI, 3.29–5.11; R2 = 0.71). Right: Scatterplot of AHI for LPSG and HSAT (regression coefficient = 4.10; 95% CI, 3.16–5.04; R2 = 0.69). AHI = apnea-hypopnea index, CI = confidence interval, coef = coefficient, HSAT = home sleep apnea test, LPSG = laboratory polysomnography, oAHI = obstructive apnea-hypopnea index.
Figure 2
Figure 2. Bland-Altman plot for LPSG and HSAT AHI.
AHI = apnea-hypopnea index, HSAT = home sleep apnea test, LPSG = laboratory polysomnography.
Figure 3
Figure 3. Bland-Altman plot for LPSG and HSAT oAHI.
HSAT = home sleep apnea test, LPSG = laboratory polysomnography, oAHI = obstructive apnea-hypopnea index.
Figure 4
Figure 4. ROC curve for HSAT and LPSG for oAHI ≥ 10 events/h and LPSG oAHI ≥ 20 events/h.
HSAT = home sleep apnea test, LPSG = laboratory polysomnography, oAHI = obstructive apnea-hypopnea index, ROC = receiver operating characteristic.
See this image and copyright information in PMC

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