Abstract
Obstructive sleep apnea (OSA) in children is a prevalent, albeit largely undiagnosed disease associated with a large spectrum of morbidities. Overnight in-lab polysomnography remains the gold standard diagnostic approach, but is time-consuming, inconvenient, and expensive, and not readily available in many places. Simplified Home Respiratory Polygraphy (HRP) approaches have been proposed to reduce costs and facilitate the diagnostic process. However, evidence supporting the validity of HRP is still scarce, hampering its implementation in routine clinical use. The objectives were: Primary; to establish the diagnostic and therapeutic decision validity of a simplified HRP approach compared to PSG among children at risk of OSA. Secondary: (a) Analyze the cost-effectiveness of the HRP versus in-lab PSG in evaluation and treatment of pediatric OSA; (b) Evaluate the impact of therapeutic interventions based on HRP versus PSG findings six months after treatment using sleep and health parameters and quality of life instruments; (c) Discovery and validity of the urine biomarkers to establish the diagnosis of OSA and changes after treatment.
Highlights
This article is an open access articleObstructive sleep apnea (OSA) is a common disorder of children characterized by habitual snoring, prolonged episodes of increased upper airway resistance, and respiratory effort with partial or complete upper airway obstruction during sleep
The main objective of the study was to assess the diagnostic validity of a Home Respiratory Polygraphy (HRP), the Apnea-Link Air system, in children with clinically suspected OSA, and compare the findings with concurrent PSG results
The DINISAS project is a multicenter, randomized, cross-over study aimed at analyzing the validity of a HRP in children with suspected OSA compared to overnight PSG
Summary
Obstructive sleep apnea (OSA) is a common disorder of children characterized by habitual snoring, prolonged episodes of increased upper airway resistance, and respiratory effort with partial or complete upper airway obstruction during sleep. Home respiratory polygraphy (HRP) has been proposed to reduce costs and facilitate the diagnostic process This method has been widely validated and implemented in the adult population, and has become a realistic alternative for the diagnosis of suspected. Apnea-Link Air (Resmed® Spain) is a simplified polygraphic recording device designed for domiciliary use It consists of a nasal canula with a pressure transducer, with thoracic and abdominal effort being measured by plethysmography, and oxyhemoglobin saturation by continuous pulse oximetry. In the quest to develop simplified approaches to the diagnosis of OSA in children and potentially identify OSA-associated morbidities, exploration of biomarkers was pioneered about a decade ago, with overall encouraging findings [42,43,44,45,46,47,48,49,50,51,52]. A large number of candidate biomarkers consisting of proteins and microRNAs have emerged, and have provided important insights into potential mechanisms underlying OSA-associated morbidities while displaying favorable diagnostic profiles
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
