Nocturnal oximetry parameters as predictors of sleep apnea severity in resource‐limited settings

Summary Nocturnal oximetry is an alternative modality for evaluating obstructive sleep apnea syndrome (OSAS) severity when polysomnography is not available. The Oxygen Desaturation (≥3%) Index (ODI3) and McGill Oximetry Score (MOS) are used as predictors of moderate‐to‐severe OSAS (apnea‐hypopnea in...

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Bibliographic Details
Published in:Journal of sleep research 2023-02, Vol.32 (1), p.e13638-n/a
Main Authors: Polytarchou, Anastasia, Ohler, Adrienne, Moudaki, Aggeliki, Koltsida, Georgia, Kanaka‐Gantenbein, Christina, Kheirandish‐Gozal, Leila, Gozal, David, Kaditis, Athanasios G.
Format: Article
Language:English
Subjects:
adenotonsillectomy
Child
children
Humans
obstructive sleep apnea syndrome
Overweight
Oximetry
Resource-Limited Settings
Sleep Apnea Syndromes - diagnosis
Sleep Apnea, Obstructive - diagnosis
Sleep Apnea, Obstructive - epidemiology
Snoring - diagnosis
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Summary:Summary Nocturnal oximetry is an alternative modality for evaluating obstructive sleep apnea syndrome (OSAS) severity when polysomnography is not available. The Oxygen Desaturation (≥3%) Index (ODI3) and McGill Oximetry Score (MOS) are used as predictors of moderate‐to‐severe OSAS (apnea‐hypopnea index‐AHI >5 episodes/h), an indication for adenotonsillectomy. We hypothesised that ODI3 is a better predictive parameter for AHI >5 episodes/h than the MOS. All polysomnograms performed in otherwise healthy, snoring children with tonsillar hypertrophy in a tertiary hospital (November 2014 to May 2019) were analysed. The ODI3 and MOS were derived from the oximetry channel of each polysomnogram. Logistic regression was applied to assess associations of ODI3 or MOS (predictors) with an AHI >5 episodes/h (primary outcome). Receiver operating characteristic (ROC) curves and areas under ROC curves were used to compare the ODI3 and MOS as predictors of moderate‐to‐severe OSAS. The optimal cut‐off value for each oximetry parameter was determined using Youden's index. Polysomnograms of 112 children (median [interquartile range] age 6.1 [3.9–9.1] years; 35.7% overweight) were analysed. Moderate‐to‐severe OSAS prevalence was 49.1%. The ODI3 and MOS were significant predictors of moderate‐to‐severe OSAS after adjustment for overweight, sex, and age (odds ratio [OR] 1.34, 95% confidence interval [CI] 1.19–1.51); and OR 4.10, 95% CI 2.06–8.15, respectively; p 
ISSN:0962-1105
1365-2869
DOI:10.1111/jsr.13638