• Sleep Breath · May 2013

    Assessment of sleep quality by pulse wave amplitude and actigraphy in children with sleep-disordered breathing: evaluation at diagnosis and under non-invasive ventilation.

    • Adriana Ramirez, Sonia Khirani, Vincent Delord, Guillaume Aubertin, Jean-Louis Pépin, and Brigitte Fauroux.
    • ADEP Assistance, Suresnes, France. ramirez.diaz.adriana@gmail.com
    • Sleep Breath. 2013 May 1; 17 (2): 827-35.

    PurposeThe aims of this study were to assess the interest of pulse wave amplitude (PWA) and actigraphy for characterizing sleep in children with sleep-disordered breathing and to evaluate PWA and actigraphy to assess the efficacy of non-invasive positive pressure ventilation (NPPV).MethodsWe performed a retrospective analysis of children with sleep-disordered breathing. Patients were classified to upper airway obstructive disease (UAO) group or non-obstructive disease (non-UAO) group. Pulse oximetry (SpO2) and PWA were measured by photoplethysmography. Autonomic micro-arousals (AA) and AA related to SpO2 desaturations above 4 % (AA + DS4%) were quantified. The fragmentation index, sleep efficiency, sleep duration, and sleep latency were measured with actigraphy. Transcutaneous carbon dioxide (PtcCO2) was monitored. NPPV was started in case of severe OSA.ResultsAA + DS4% were more common in the UAO (n = 15) than the non-UAO group (n = 13) (p < 0.001). All nocturnal gas exchange parameters were worse in the UAO group. Eight children required NPPV. AA + DS4%, maximal PtcCO2, percent of time with PtcCO2 > 50 mmHg, and percent of time with SpO2 < 90 % decreased significantly after 1 month of NPPV.ConclusionsThe analysis of AA + DS4% is very informative for the grading of the severity of OSA and for the efficacy of NPPV in children with sleep-disordered breathing.

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