Age and seasons influence on at-home pulse oximetry results in children evaluated for suspected obstructive sleep apnea

Martino Pavone,Nicola Ullmann,Valentina Negro,Renato Cutrera,Serena Caggiano,Elisabetta Verrillo

doi:10.1186/s13052-017-0428-y

Martino Pavone, Nicola Ullmann + Show 4 more

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https://doi.org/10.1186/s13052-017-0428-y

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Abstract

BackgroundSeasonal variability on obstructive sleep apnea has already been studied by polysomnography in children. Winter and spring season emerged as critical periods. No data are currently available for pulse oximetry performed at home. The aim of our study was to evaluate the effect of seasonality and age on the results of at-home pulse oximetry performed in children referred for suspected OSA.MethodsWe retrospectively studied 781 children (64.3% Males), aged 4.9 ± 2.5 years. For all patients, we evaluated both pulse oximetry metrics and the McGill Oximetry Score. Variables for seasonal groups were assessed using Kruskal-Wallis test. A logistic regression model was performed to assess the relationship between patients’ main characteristics, season period and the likelihood to have an abnormal McGill Oximetry Score.ResultsPatients recorded during winter were significantly younger (p < 0.02), nadir SpO2 was significantly lower (p < 0.002) and DI4 significantly higher than during others seasons (p < 0.005). Moreover, patients recorded during winter were nearly 2 times more likely to have an abnormal MOS (aOR 1.949). The logistic regression showed that also younger age (p < 0.0001) was associated with a higher risk to find an abnormal pulse oximetry.ConclusionsIn our study, the winter season confirms to be a critical period for pulse-oximetry and it should be taken into account by clinicians for a correct interpretation of tests. Our data show that also younger age affects the prevalence of abnormal at-home pulse oximetry in children.

Highlights

Seasonal variability on obstructive sleep apnea has already been studied by polysomnography in children
In children with abnormal McGill Oximetry Score (MOS), mean and nadir oxygen saturation (SpO2) were significantly lower and time spent with SpO2 < 90% (% total effective recording time (TERT)) significantly higher (p < 0.0001 for all parameters)
Evaluating pulse oximetry metric results by season of recordings, we found that winter was characterized by a lower nadir SpO2, a greater amount of time spent with SpO2 < 90% (%TERT), and a higher dips ≥4%/hrs of study (DI4) compared to other seasons

Summary

Introduction

Seasonal variability on obstructive sleep apnea has already been studied by polysomnography in children. No data are currently available for pulse oximetry performed at home. The aim of our study was to evaluate the effect of seasonality and age on the results of athome pulse oximetry performed in children referred for suspected OSA. Obstructive Sleep Apnea (OSA) in children is characterized by partial and/or intermittent complete upper airway obstruction that may disrupt normal sleep ventilation and EEG typical patterns [1]. Adenotonsillar hypertrophy is the most common risk factor for developing OSA in children. Growing attention has been pointed out to other risk factors such as obesity, craniofacial anomalies, and neuromuscular disease [1,2,3,4]. Symptoms include snoring, laboured breathing, witnessed apnea, profuse sweating, disturbed sleep, and daytime neurobehavioral problems. Complications include neurocognitive impairment, behavioural, cardiovascular, and metabolic issues [5, 6]

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