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.

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.