Evaluation of sleep apnoea in children using tracheal sounds and suprasternal pressure

Abstract

Introduction: The AASM recommends the use of oronasal thermistor and nasal cannulas to detect respiratory events and respiratory inductance plethysmography (RIP) to characterise apnoeas. However nasal cannulas have a poor scorability. The aim of the study was to evaluate the use of tracheal sounds (TS) and suprasternal pressure (SSP) as an alternative of oronasal thermistor and nasal cannulas for the diagnosis of sleep apnoea in children. Materials and methods: Polysomnographic recordings of 17 children were used. We compared the detection and characterisation of apnoeas by 3 methods: AASM using standard signals (AASM scoring), combination of TS and SSP with RIPflow and pulse oximetry (SpO2) without nasal cannulas (scoring 2) and TS and SSP combined with SpO2 (scoring 3). Results: AASM scoring identified 1149 apnoeas, scoring 2 and 3 identified 1054 and 1049 apnoeas respectively. Sensitivity for apnoeas detection was 92% (scoring 2) and 91% (scoring 3). For apnoea characterisation, scoring 2 sensitivity and specificity were 97% and 100%, 77% and 99% and 98% and 98% for obstructive, mixed and central apnoeas respectively. For scoring 3, they were 96% and 100%, 90% and 96% and 88% and 98% for obstructive, mixed and central apnoeas respectively. Conclusions: The combination of TS and SSP with RIP flow and SpO2 without oronasal thermistor and nasal cannulas can be used for the detection and characterisation of apnoeas in children, and may be used as an alternative when these signals are not available.