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CC BY-NC-ND 4.0 · Sleep Sci
DOI: 10.1055/s-0045-1802967
Original Article

Feasibility of High-Resolution Oximeter Plus Actigraphy Combined with a Cloud-Based Algorithm for the Detection of Obstructive Sleep Apnea in Children with Craniofacial Anomalies

Sergio Henrique Kiemle Trindade 
1   Sleep Studies Unit, Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
2   Faculdade de Medicina de Bauru, Universidade de São Paulo (FMBRU-USP), Bauru, SP, Brazil
3   Department of Otorhinolaryngology, Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Universidade de São Paulo (USP), Bauru, SP, Brazil
,
Fábio Luiz Banhara 
1   Sleep Studies Unit, Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
,
Leide Vilma Fidélis da Silva
1   Sleep Studies Unit, Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
,
Sara Quaglia de Campos Giampá 
4   Laboratory of Medical Research on Sleep (LIM/63), Division of Pulmonology, Department of Cardiopulmonology, Instituto do Coração (InCor), Hospital das Clínicas, Faculty of Medicine, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
,
Lais Mota Furtado Sena
3   Department of Otorhinolaryngology, Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Universidade de São Paulo (USP), Bauru, SP, Brazil
,
Ivy Kiemle Trindade-Suedam 
1   Sleep Studies Unit, Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
5   Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru SP, Brazil
› Institutsangaben Funding Source The authors declare that they did not receive funding from agencies in the public, private, or non-profit sectors to conduct the present study.
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Abstract

Objective

To verify the feasibility of high-resolution oximeter plus actigraphy combined with a cloud-based algorithm for the detection of obstructive sleep apnea (OSA) in children with craniofacial anomalies.

Materials and Methods

In the present prospective, cross-sectional study, we evaluated children previously submitted to primary surgical palate repair with a genetically confirmed diagnosis of Treacher Collins syndrome (TCS), non-syndromic Robin sequence (NSRS), or non-syndromic cleft palate (NSCP). The children underwent a clinical evaluation, had their anthropometric measures taken, and were submitted to OSA detection using high-resolution oximeter plus actigraphy combined with a cloud-based algorithm (Biologix Sleep Test, Biologix Sistemas S.A., São Paulo, SP, Brazil).

Results

In total, 64 children (TCS: n = 16; NSRS: n = 29; NSCP: n = 19) were included in the final analysis (mean age: 10 ± 2 years; 64% of female patients). The Biologix Sleep Test showed that 59 patients (92%) presented OSA according to the oxygen desaturation index (ODI): 36 (56%) were diagnosed with mild OSA, 19 (30%), with moderate OSA, and 4 (6%), with severe OSA. The high-resolution oximeter recording showed excellent signal quality in 94.53 ± 5.29% of the exams, with a success rate of exams on the first night of 90%. No significant difference was found in terms of ODI among the subgroups (p > 0.05). A significant relationship was observed between increased ODI with greater hypoxic burden and lower estimated sleep efficiency. The multiple linear regression analysis demonstrated a significant association between changes in total ODI with lower estimated sleep efficiency and sleep ODI.

Conclusion

High-resolution oximeter plus actigraphy combined with a cloud-based algorithm demonstrated adequate feasibility and applicability for OSA detection in children with craniofacial anomalies.

Keywords

oximetry - actigraphy - sleep apnea - obstructive - Treacher Collins syndrome - Pierre Robin syndrome


Publikationsverlauf

Eingereicht: 11. Oktober 2024

Angenommen: 06. Januar 2025

Artikel online veröffentlicht:
27. März 2025

© 2025. Brazilian Sleep Academy. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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Bibliographical Record
Sergio Henrique Kiemle Trindade, Fábio Luiz Banhara, Leide Vilma Fidélis da Silva, Sara Quaglia de Campos Giampá, Lais Mota Furtado Sena, Ivy Kiemle Trindade-Suedam. Feasibility of High-Resolution Oximeter Plus Actigraphy Combined with a Cloud-Based Algorithm for the Detection of Obstructive Sleep Apnea in Children with Craniofacial Anomalies. Sleep Sci ; : s00451802967.
DOI: 10.1055/s-0045-1802967
 

  • References

  • 1 Marcus CL, Brooks LJ, Draper KA. et al; American Academy of Pediatrics. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2012; 130 (03) e714-e755
    CrossrefPubMedSuche in Google Scholar
  • 2 Piotto M, Gambadauro A, Rocchi A. et al. Pediatric Sleep Respiratory Disorders: A Narrative Review of Epidemiology and Risk Factors. Children (Basel) 2023; 10 (06) 955
    PubMedSuche in Google Scholar
  • 3 Robison JG, Otteson TD. Increased prevalence of obstructive sleep apnea in patients with cleft palate. Arch Otolaryngol Head Neck Surg 2011; 137 (03) 269-274
    CrossrefPubMedSuche in Google Scholar
  • 4 Nicholas Jungbauer W, Poupore NS, Nguyen SA, Carroll WW, Pecha PP. Obstructive sleep apnea in children with nonsyndromic cleft palate: a systematic review. J Clin Sleep Med 2022; 18 (08) 2063-2068
    CrossrefPubMedSuche in Google Scholar
  • 5 Marszałek-Kruk BA, Wójcicki P, Dowgierd K, Śmigiel R. Treacher Collins Syndrome: Genetics, Clinical Features and Management. Genes (Basel) 2021; 12 (09) 1392
    CrossrefPubMedSuche in Google Scholar
  • 6 Hsieh ST, Woo AS. Pierre Robin Sequence. Clin Plast Surg 2019; 46 (02) 249-259
    CrossrefPubMedSuche in Google Scholar
  • 7 Breugem CC, Evans KN, Poets CF. et al. Best practices for the diagnosis and evaluation of infants with Robin sequence: a clinical consensus report. JAMA Pediatr 2016; 170 (09) 894-902
    CrossrefPubMedSuche in Google Scholar
  • 8 Varadarajan S, Balaji TM, Raj AT. et al. Genetic Mutations Associated with Pierre Robin Syndrome/Sequence: A Systematic Review. Mol Syndromol 2021; 12 (02) 69-86
    CrossrefPubMedSuche in Google Scholar
  • 9 Freitas RDS, do Prado D, Guarezi Nasser IJ, Peressutti C, Ogawa VS. Pierre Robin Sequence and Respiratory Distress: Long-Term Evolution in Patients Submitted to the Conservative Treatment. J Craniofac Surg 2023; 34 (04) 1267-1270
    CrossrefPubMedSuche in Google Scholar
  • 10 Wright M, Cortina-Borja M, Knowles R, Urquhart DS. Global birth prevalence of Robin sequence in live-born infants: a systematic review and meta-analysis. Eur Respir Rev 2023; 32 (170) 230133
    CrossrefPubMedSuche in Google Scholar
  • 11 Berry RB, Albertario CL, Harding SM. et al. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, version 2.5. American Academy of Sleep Medicine; Darien, IL: 2018
    Suche in Google Scholar
  • 12 Logjes RJH, MacLean JE, de Cort NW. et al. Objective measurements for upper airway obstruction in infants with Robin sequence: what are we measuring? A systematic review. J Clin Sleep Med 2021; 17 (08) 1717-1729
    CrossrefPubMedSuche in Google Scholar
  • 13 Oceja E, Rodríguez P, Jurado MJ. et al. Validity and Cost-Effectiveness of Pediatric Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children: Rationale, Study Design, and Methodology. Methods Protoc 2021; 4 (01) 9
    CrossrefPubMedSuche in Google Scholar
  • 14 Hasan R, Genta PR, Pinheiro GDL. et al. Validation of an overnight wireless high-resolution oximeter for the diagnosis of obstructive sleep apnea at home. Sci Rep 2022; 12 (01) 15136
    CrossrefPubMedSuche in Google Scholar
  • 15 Teixeira RCP, Cahali MB. In-Laboratory Polysomnography Worsens Obstructive Sleep Apnea by Changing Body Position Compared to Home Testing. Sensors (Basel) 2024; 24 (09) 2803
    CrossrefPubMedSuche in Google Scholar
  • 16 Pinheiro GDL, Cruz AF, Domingues DM. et al. Validation of an Overnight Wireless High-Resolution Oximeter plus Cloud-Based Algorithm for the Diagnosis of Obstructive Sleep Apnea. Clinics (Sao Paulo) 2020; 75: e2414
    CrossrefPubMedSuche in Google Scholar
  • 17 World health organization (WHO). Who Antrhro and macros, software (version 3.2.2, september 2020). Department of nutrition, World health organization; Geneva: 2020. [cited 2024 august 18]. Available from: https://who.int/entity/childgrowth/software/en/
    Suche in Google Scholar
  • 18 Sheldon SH. Polysomnography in Infants and Children. In: Sheldon SH, Ferber R, Kryger M, Gozal D. eds. Principle and Practice of Pediatric Sleep Medicine. 2nd Ed.. Elsevier Inc.; 2014
    Suche in Google Scholar
  • 19 de Carvalho LB, do Prado LB, Ferrreira VR. et al. Symptoms of sleep disorders and objective academic performance. Sleep Med 2013; 14 (09) 872-876
    CrossrefPubMedSuche in Google Scholar
  • 20 van Lieshout MJS, Joosten KFM, Koudstaal MJ. et al. Management and outcomes of obstructive sleep apnea in children with Robin sequence, a cross-sectional study. Clin Oral Investig 2017; 21 (06) 1971-1978
    CrossrefPubMedSuche in Google Scholar
  • 21 Kaditis A, Kheirandish-Gozal L, Gozal D. Pediatric OSAS: Oximetry can provide answers when polysomnography is not available. Sleep Med Rev 2016; 27: 96-105
    CrossrefPubMedSuche in Google Scholar
  • 22 van der Plas PPJM, van Heesch GGM, Koudstaal MJ. et al. Non-Surgical Respiratory Management in Relation to Feeding and Growth in Patients with Robin Sequence; a Prospective Longitudinal Study. Cleft Palate Craniofac J 2023; 62 (01) 10 556656231199840
    Suche in Google Scholar
  • 23 Manica D, Schweiger C, Sekine L. et al. Association of polysomnographic parameters with clinical symptoms severity grading in Robin sequence patients: a cohort nested cross-sectional study. Sleep Med 2018; 43: 96-99
    CrossrefPubMedSuche in Google Scholar
  • 24 Gozal D, Tan HL, Kheirandish-Gozal L. Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision. J Clin Med 2020; 9 (03) 888
    CrossrefPubMedSuche in Google Scholar
  • 25 Akre H, Øverland B, Åsten P, Skogedal N, Heimdal K. Obstructive sleep apnea in Treacher Collins syndrome. Eur Arch Otorhinolaryngol 2012; 269 (01) 331-337
    CrossrefPubMedSuche in Google Scholar
  • 26 Plomp RG, Bredero-Boelhouwer HH, Joosten KFM. et al. Obstructive sleep apnoea in Treacher Collins syndrome: prevalence, severity and cause. Int J Oral Maxillofac Implants 2012; 41 (06) 696-701
    CrossrefPubMedSuche in Google Scholar
  • 27 Savini S, Ciorba A, Bianchini C. et al. Assessment of obstructive sleep apnoea (OSA) in children: an update. Acta Otorhinolaryngol Ital 2019; 39 (05) 289-297
    CrossrefPubMedSuche in Google Scholar
  • 28 Moraleda-Cibrián M, Edwards SP, Kasten SJ, Berger M, Buchman SR, O'Brien LM. Symptoms of sleep disordered breathing in children with craniofacial malformations. J Clin Sleep Med 2014; 10 (03) 307-312
    CrossrefPubMedSuche in Google Scholar
  • 29 Zaballa K, Singh J, Waters K. The management of upper airway obstruction in Pierre Robin Sequence. Paediatr Respir Rev 2023; 45: 11-15
    PubMedSuche in Google Scholar
  • 30 Ehsan Z, Kurian C, Weaver KN. et al. Longitudinal Sleep Outcomes in Neonates With Pierre Robin Sequence Treated Conservatively. J Clin Sleep Med 2019; 15 (03) 477-482
    CrossrefPubMedSuche in Google Scholar
  • 31 Rashid NH, Zaghi S, Scapuccin M, Camacho M, Certal V, Capasso R. The Value of Oxygen Desaturation Index for Diagnosing Obstructive Sleep Apnea: A Systematic Review. Laryngoscope 2021; 131 (02) 440-447
    CrossrefPubMedSuche in Google Scholar
  • 32 Abu K, Khraiche ML, Amatoury J. Obstructive sleep apnea diagnosis and beyond using portable monitors. Sleep Med 2024; 113: 260-274
    CrossrefPubMedSuche in Google Scholar
  • 33 Chen F, Chen K, Zhang C. et al. Evaluating the clinical value of the hypoxia burden index in patients with obstructive sleep apnea. Postgrad Med 2018; 130 (04) 436-441
    CrossrefPubMedSuche in Google Scholar
  • 34 Chung F, Liao P, Elsaid H, Islam S, Shapiro CM, Sun Y. Oxygen desaturation index from nocturnal oximetry: a sensitive and specific tool to detect sleep-disordered breathing in surgical patients. Anesth Analg 2012; 114 (05) 993-1000
    CrossrefPubMedSuche in Google Scholar
  • 35 Behar JA, Palmius N, Zacharie S. et al. Single-channel oximetry monitor versus in-lab polysomnography oximetry analysis: does it make a difference?. Physiol Meas 2020; 41 (04) 044007
    CrossrefPubMedSuche in Google Scholar
  • 36 Rodrigues Filho JC, Neves DD, Velasque L, Maranhão AA, de Araujo-Melo MH. Diagnostic performance of nocturnal oximetry in the detection of obstructive sleep apnea syndrome: a Brazilian study. Sleep Breath 2020; 24 (04) 1487-1494
    CrossrefPubMedSuche in Google Scholar
  • 37 Dewan NA, Nieto FJ, Somers VK. Intermittent hypoxemia and OSA: implications for comorbidities. Chest 2015; 147 (01) 266-274
    CrossrefPubMedSuche in Google Scholar
  • 38 Harrison EI, Roth RH, Lobo JM. et al. Sleep time and efficiency in patients undergoing laboratory-based polysomnography. J Clin Sleep Med 2021; 17 (08) 1591-1598
    CrossrefPubMedSuche in Google Scholar
  • 39 Brockmann PE, Schaefer C, Poets A, Poets CF, Urschitz MS. Diagnosis of obstructive sleep apnea in children: a systematic review. Sleep Med Rev 2013; 17 (05) 331-340
    CrossrefPubMedSuche in Google Scholar
  • 40 Bhattacharjee R. Ready for Primetime? Home Sleep Apnea Tests for Children. J Clin Sleep Med 2019; 15 (05) 685-686
    CrossrefPubMedSuche in Google Scholar
  • 41 Ioan I, Weick D, Schweitzer C, Guyon A, Coutier L, Franco P. Feasibility of parent-attended ambulatory polysomnography in children with suspected obstructive sleep apnea. J Clin Sleep Med 2020; 16 (07) 1013-1019
    CrossrefPubMedSuche in Google Scholar