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

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?2, percent of time with PtcCO₂?>?50 mmHg, and percent of time with SpO₂?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.