How Accurate Are Home Sleep Monitors in Diagnosing Pediatric OSA?

Type III portable sleep monitors (PSMs) may have value for diagnosing pediatric obstructive sleep apnea (OSA); however, current evidence does not support the use of type IV PSMs for this purpose, according to findings presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) 2022 Annual Meeting and OTO Experience, held in Philadelphia, Pennsylvania, September 10 to 14, 2022.

Despite the development and commercialization of at-home use type III and type IV PSMs, the American Academy of Sleep Medicine has yet to recommend their use among children. Researchers therefore assessed the diagnostic accuracies of type III and type IV PSMs for the diagnosis of OSA in children.

The researchers conducted a systematic review using the Embase, MEDLINE, and Web of Science databases for publications that evaluated the diagnostic accuracy of PSMs in pediatric OSA. They found 60 studies that matched their criteria, of which 47 assessed the diagnostic accuracy of type IV PSMs for the diagnosis of OSA. Among those, 14 revealed sensitivities greater than 80% and 8 found specificities greater than 80% for diagnosing OSA (apnea-hypopnea index [AHI]≥1).

Of the 14 studies evaluating the diagnosis accuracy of moderate-to-severe OSA through statistical and machine learning analysis (SMLA) of type IV PSM data, 12 studies showed specificity greater than 80% and 10 studies revealed sensitivity in the 68% to 79% range.

Of the 7 studies evaluating the accuracy of diagnosing moderate-to-severe OSA (AHI≥5) through type III PSMs, 6 studies showed sensitivities or specificities greater than 80%.

“Our results may support the use of type III PSMs in children to diagnose OSA, although concerns regarding feasibility, acceptability, and cost-effectiveness of such tests remain to be addressed to support their widespread implementation,” the researchers concluded, noting that evidence did not support the use of type IV PSMs for diagnosing pediatric OSA. “Current research suggests a shift toward the multidimensional assessment of a combination of variables,” the researchers added.

Reference

Landry V, Semsar-Karerooni K, Chen T, Gurberg J, Nguyen L H-N. Diagnostic accuracy of home sleep monitors in pediatric obstructive sleep apnea: a systematic review. Otolaryngol Head Neck Surg. 2022;167(1 suppl):P294.