Detection of respiratory events using pulse rate in children with and without obstructive sleep apnea†‡

  1. Anke Noehren MD1,2,
  2. Pablo E. Brockmann MD1,3,
  3. Michael S. Urschitz MD, MSc1,*,
  4. Christiane Sokollik MD4,
  5. Martin Schlaud MD5,
  6. Christian F. Poets MD1

Article first published online: 13 APR 2010

DOI: 10.1002/ppul.21196

Issue

Pediatric Pulmonology

Pediatric Pulmonology

Volume 45, Issue 5, pages 459–468, May 2010

Additional Information

How to Cite

Noehren, A., Brockmann, P. E., Urschitz, M. S., Sokollik, C., Schlaud, M. and Poets, C. F. (2010), Detection of respiratory events using pulse rate in children with and without obstructive sleep apnea. Pediatric Pulmonology, 45: 459–468. doi: 10.1002/ppul.21196

Author Information

  1. 1

    Department of Neonatology, University Children's Hospital, Tuebingen, Germany

  2. 2

    Department of Cardiology, Krankenhaus an der Weser, Hameln, Germany

  3. 3

    Department of Paediatrics, Pontificia Universidad Catolica de Chile, Santiago de Chile

  4. 4

    Department of Paediatrics, University Children's Hospital, Tuebingen, Germany

  5. 5

    Department of Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany

*Paediatric Sleep Medicine, Department of Neonatology, University Children's Hospital Tuebingen, Calwerstr. 7, 72076 Tuebingen, Germany.

  1. †

    The authors have no conflict of interest to declare.

  2. ‡

    Anke Noehren and Pablo E. Brockmann contributed equally to this work.

Publication History

  1. Issue published online: 21 APR 2010
  2. Article first published online: 13 APR 2010
  3. Manuscript Accepted: 20 NOV 2009
  4. Manuscript Revised: 15 NOV 2009
  5. Manuscript Received: 19 MAY 2009

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Keywords:

  • polysomnography;
  • heart rate;
  • hypopnea;
  • oximetry;
  • arousal;
  • snoring

Abstract

Oximetry is a simple but insensitive diagnostic test modality for obstructive sleep apnea (OSA) in children. Sensitivity for OSA may be enhanced if pulse rate is analyzed in conjunction with oxygen saturation. We analyzed 25 ambulatory polysomnographic recordings obtained from children with (n = 5) and without (n = 20) OSA. To assess sensitivity and specificity, pulse rate increases were determined during respiratory (i.e., apneas and hypopneas; n = 965) and non-respiratory sleep events (i.e., body movements; n = 1,197), and contrasted to baseline fluctuations (n = 209). The absolute pulse rate increase (APRI) was the parameter that differentiated best between baseline fluctuations and sleep events (area under the receiver operating characteristic curve [AUC]: 0.88). At a cutoff value of 12 beats per minute, APRI showed a sensitivity and specificity for detecting sleep events of 0.81 each. However, AUC was lower for the differentiation between respiratory and non-respiratory sleep events (0.77) and between central and obstructive respiratory events (0.68). In OSA cases, influencing factors for APRI following respiratory events were age, occurrence of a body movement, and severity of concomitant oxygen desaturation. We conclude that pulse rate analysis may be used to detect respiratory events in oximetry recordings in children. Pediatr Pulmonol. 2010; 45:459–468. © 2010 Wiley-Liss, Inc.

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