Study Objectives:

Children with Down syndrome (DS) are at risk of obstructive sleep apnea (OSA), but the access to sleep lab polysomnography (PSG) is limited. Simplified techniques are needed, such as polygraphy coupled with pulse transit time (PTT-PG) that detects respiratory events and total autonomic arousals index (PTTAI). Our objective was to assess the ability of PTT-PG compared to PSG to diagnose OSA in children with DS.

Methods:

In this prospective multicenter study, patients with DS underwent a full-night PSG coupled with PTT. Sleep questionnaires (Sleep Disturbance Scale for Children [SDSC] and Pediatric Sleep Questionnaire [PSQ]) were filled by parents. PSG and PTT-PG results were compared to test their sensibility and specificity to diagnose OSA.

Results:

A total of 53 DS patients were included, their median age was 9.3 years. An obstructive apnea-hypopnea index (OAHI) by PSG >1 event/h was found in 36 (68%) patients, OAHI was > 1 and < 5 events/h in 18 (34%), ≥ 5 and < 10 events/h in 11 (21%), and ≥10 events/h in 7 (13%). OAHI was larger in PSG than in PTT-PG (p=0.0005). For OSA diagnosis, the sensitivity was excellent for OAHI by PTT-PG if added total PTTAI was > 1 event/h (1.0) and the specificity was high for PSQ (0.88) and OAHI > 1 event/h in PTT-PG (1.0).

Conclusions:

More than two-thirds of children with DS referred for screening by genetic specialist had OSA diagnosed by PSG. With its excellent sensitivity and specificity, PTT-PG could be a good and simplified alternative to PSG to diagnose OSA in children with DS.

中文翻译：

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脉搏传导时间作为唐氏综合症儿童 OSA 的诊断测试

学习目标：

患有唐氏综合症 (DS) 的儿童有患阻塞性睡眠呼吸暂停 (OSA) 的风险，但获得睡眠实验室多导睡眠图 (PSG) 的机会有限。需要简化的技术，例如检测呼吸事件和总自主神经觉醒指数 (PTTAI) 的脉搏传导时间 (PTT-PG) 耦合多描记法。我们的目标是评估 PTT-PG 与 PSG 相比诊断 DS 儿童 OSA 的能力。

方法：

在这项前瞻性多中心研究中，DS 患者接受了整夜 PSG 联合 PTT。父母填写了睡眠问卷（儿童睡眠障碍量表 [SDSC] 和儿科睡眠问卷 [PSQ]）。比较 PSG 和 PTT-PG 结果，以测试它们诊断 OSA 的敏感性和特异性。

结果：

共纳入 53 名 DS 患者，中位年龄为 9.3 岁。在 36 名 (68%) 患者中发现阻塞性呼吸暂停低通气指数 (OAHI) 通过 PSG >1 次事件/小时，OAHI > 1 且 < 5 次事件/小时，18 例 (34%)，≥ 5 次且 < 10 次事件/ 11 人（21%）h，7 人（13%）≥10 次事件/小时。PSG 中的 OAHI 大于 PTT-PG ( p=0.0005 )。对于 OSA 诊断，如果添加的总 PTTAI > 1 事件/小时 (1.0)，则通过 PTT-PG 对 OAHI 的敏感性非常好，并且在 PTT-PG 中对 PSQ (0.88) 和 OAHI > 1 事件/小时的特异性很高 (1.0) ).

结论：

超过三分之二的 DS 儿童被遗传专家转介进行筛查，PSG 诊断出患有 OSA。凭借其出色的灵敏度和特异性，PTT-PG 可以成为 PSG 诊断 DS 儿童 OSA 的一种良好且简化的替代方法。