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

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Abstract

Purpose

The 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).

Methods

We 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.

Results

AA + 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.

Conclusions

The 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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Financial support

The research of Brigitte Fauroux is supported by the Association Française contre les Myopathies (AFM); ADEP Assistance, Vaincre la Mucoviscidose (VLM); Assistance Publique-Hôpitaux de Paris, Inserm, and Université Pierre et Marie Curie-Paris6.

Conflict of interest

None of the authors has any conflict of interest to disclose. JL Pépin and his institution have a patent pending for sleep apnea diagnosis tool.

Author information

Authors and Affiliations

  1. ADEP Assistance, Suresnes, France

    Adriana Ramirez

  2. INSERM U 955, Paris, France

    Sonia Khirani

  3. AP-HP, Pediatric Pulmonology Department, Hôpital Armand Trousseau, Paris, France

    Vincent Delord & Guillaume Aubertin

  4. HP2 Laboratory (Hypoxia: Pathophysiology), Department of Physiology and Rehabilitation, Grenoble University Hospital, INSERM U 1042, Grenoble, 38042, France

    Jean-Louis Pépin

  5. AP-HP, Pediatric Pulmonary Department, Hôpital Armand Trousseau, Université Pierre et Marie Curie-Paris6, INSERM U 955, 28 avenue du Docteur Arnold Netter, Paris, 75012, France

    Brigitte Fauroux

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  1. Adriana Ramirez
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  2. Sonia Khirani
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  3. Vincent Delord
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  4. Guillaume Aubertin
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Correspondence to Brigitte Fauroux.

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Ramirez, A., Khirani, S., Delord, V. et al. Assessment of sleep quality by pulse wave amplitude and actigraphy in children with sleep-disordered breathing: evaluation at diagnosis and under non-invasive ventilation. Sleep Breath 17, 827–835 (2013). https://doi.org/10.1007/s11325-012-0771-6

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  • DOI: https://doi.org/10.1007/s11325-012-0771-6

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