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Severe obstructive sleep apnea in children with syndromic craniosynostosis: analysis of pulse transit time.
Yang, Sumin; van Twist, Eris; van Heesch, Gwen G M; de Jonge, Rogier C J; Louter, Maartje; Tasker, Robert C; Mathijssen, Irene M J; Joosten, Koen F M.
Afiliación
  • Yang S; Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
  • van Twist E; Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
  • van Heesch GGM; Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
  • de Jonge RCJ; Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
  • Louter M; Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands.
  • Tasker RC; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
  • Mathijssen IMJ; Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
  • Joosten KFM; Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands.
J Clin Sleep Med ; 20(8): 1233-1240, 2024 Aug 01.
Article en En | MEDLINE | ID: mdl-38456822
ABSTRACT
STUDY

OBJECTIVES:

We examined the association between pulse transit time (PTT) and obstructive sleep apnea (OSA) in children with syndromic craniosynostosis (SCS), where OSA is a common problem and may cause cardiorespiratory disturbance.

METHODS:

A retrospective study of children (age < 18 years) with SCS and moderate-to-severe OSA (ie, obstructive apnea-hypopnea index ≥ 5) or no OSA (obstructive apnea-hypopnea index < 1) who underwent overnight polysomnography. Children without SCS and normal polysomnography were included as controls. Reference intervals for PTT were computed by nonparametric bootstrap analysis. Based on reference intervals of controls, the sensitivity and specificity of PTT to detect OSA were determined. In a linear mixed model, the explanatory variables assessed were sex, age, sleep stage, and time after obstructive events.

RESULTS:

In all 68 included children (19 with SCS with OSA, 30 with SCS without OSA, 19 controls), obstructive events occurred throughout all sleep stages, most prominently during rapid eye movement (REM) sleep and non-REM sleep stages N1 and N2, with evident PTT changes. The greatest reductions were observed 4-8 seconds after an event (P < .05). In SCS with OSA, PTT reference intervals were lower during all sleep stages compared with SCS without OSA. The highest sensitivity was observed during N1 (55.5%), and the highest specificity during REM sleep (76.5%). The lowest PTT values were identified during N1.

CONCLUSIONS:

Obstructive events occur throughout all sleep stages with transient reductions in PTT. However, PTT as a variable for OSA detection is limited by its sensitivity and specificity. CITATION Yang S, van Twist E, van Heesch GGM, et al. Severe obstructive sleep apnea in children with syndromic craniosynostosis analysis of pulse transit time. J Clin Sleep Med. 2024;20(8)1233-1240.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Polisomnografía / Craneosinostosis / Apnea Obstructiva del Sueño / Análisis de la Onda del Pulso Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: J Clin Sleep Med Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Polisomnografía / Craneosinostosis / Apnea Obstructiva del Sueño / Análisis de la Onda del Pulso Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: J Clin Sleep Med Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos