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Ioan I, Renard E, Da Mota S, Bonabel C, Tiotiu A, Franco P, Coutier L, Schweitzer C. Unattended home sleep studies for the diagnosis of obstructive sleep apnea in a population of French children. Sleep Med 2023; 102:117-122. [PMID: 36640557 DOI: 10.1016/j.sleep.2023.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/31/2022] [Accepted: 01/01/2023] [Indexed: 01/04/2023]
Abstract
BACKGROUND Ambulatory exams were preferred in children during the COVID-19 pandemic. Polysomnography (PSG), the gold standard for obstructive sleep apnea (OSA) diagnosis, requires several leads and sensors to be attached to the child's body. Children are more comfortable with respiratory polygraphic (RP) recording, which needs fewer sensors. OBJECTIVE To compare respiratory parameters obtained by home RP with those obtained by home PSG with the device installed at the child's home by a trained sleep nurse from a national health care provider. METHODS Data from home PSGs performed in children aged 2-19 years were retrospectively included. The obstructive apnea-hypopnea index (OAHI) was computed in PSG and then in RP after removing the sleep signals. The two indexes were compared using non-parametric paired Wilcoxon rank test, Bland-Altman analysis and sensitivity-specificity analysis. RESULTS 44 PSGs of 44 children were included with only 34 (77%) PSGs interpretable. Median (min-max) OAHI was significantly underestimated in RP than in PSG (2.2 (0-25) vs 4.0 (0.4-28), p < 0.0001), confirmed also by the Bland-Altman diagram, the magnitude of the difference being mean ± standard deviation -1.7 ± 1.7. The sensitivity and specificity of OAHI in RP to identify an OAHI ≥2/h in PSG was 0.91 for both. CONCLUSION Unattended ambulatory RP performed at child's house and installed under carefully controlled conditions is a useful exam for diagnosing OSA in children with or without comorbidities. However, RP must be installed in a supervised environment and interpreted with caution as it tends to underestimate OSA severity.
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Affiliation(s)
- Iulia Ioan
- Service d'Explorations Fonctionnelles Pédiatriques, Hôpital d'Enfants, Centre Hospitalier Universitaire de Nancy, France; EA3450-DevAH, Faculté de Médecine, Université de Lorraine, France.
| | - Emeline Renard
- Service de Médecine Infantile, Centre Hospitalier Universitaire de Nancy, France
| | - Sofia Da Mota
- Service d'Explorations Fonctionnelles Pédiatriques, Hôpital d'Enfants, Centre Hospitalier Universitaire de Nancy, France
| | - Claude Bonabel
- Service d'Explorations Fonctionnelles Pédiatriques, Hôpital d'Enfants, Centre Hospitalier Universitaire de Nancy, France; EA3450-DevAH, Faculté de Médecine, Université de Lorraine, France
| | - Angelica Tiotiu
- EA3450-DevAH, Faculté de Médecine, Université de Lorraine, France; Service de Pneumologie, Centre Hospitalier Universitaire de Nancy, France
| | - Patricia Franco
- Service Epilepsie, Sommeil, Explorations Fonctionnelles Neurologiques Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France; U1028, CNRL, Université de Lyon 1, France
| | - Laurianne Coutier
- U1028, CNRL, Université de Lyon 1, France; Service de pneumologie infantile, Allergologie et centre de référence en mucoviscidose, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Cyril Schweitzer
- EA3450-DevAH, Faculté de Médecine, Université de Lorraine, France; Service de Médecine Infantile, Centre Hospitalier Universitaire de Nancy, France
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Papadopoulos NG, Mathioudakis AG, Custovic A, Deschildre A, Phipatanakul W, Wong G, Xepapadaki P, Abou‐Taam R, Agache I, Castro‐Rodriguez JA, Chen Z, Cros P, Dubus J, El‐Sayed ZA, El‐Owaidy R, Feleszko W, Fierro V, Fiocchi A, Garcia‐Marcos L, Goh A, Hossny EM, Huerta Villalobos YR, Jartti T, Le Roux P, Levina J, López García AI, Ramos ÁM, Morais‐Almeida M, Murray C, Nagaraju K, Nagaraju MK, Navarrete Rodriguez EM, Namazova‐Baranova L, Nieto Garcia A, Pozo Beltrán CF, Ratchataswan T, Rivero Yeverino D, Rodríguez Zagal E, Schweitzer CE, Tulkki M, Wasilczuk K, Xu D, Alekseeva A, Almeida B, Andre M, Arimova P, Blonde A, Cunningham A, Da Mota S, Efendieva K, Kalugina V, Kiefer S, Klein A, López CGC, López JJR, Moratellti C, Fuentes Pérez M, Simermann M, Tapia JSP, Tatopoulos A, Vishneva E, Volkov Κ, Bacharier L, Bonini M, Craig T, Diamant Z, Ducharme FM, Gern JE, Grigg J, Hamelmann EH, Hedlin G, Jartti T, Kalayci O, Kaplan A, Konradsen J, Kuna P, Lau S, Le Souef P, Lemanske RF, Makela MJ, Matricardi PM, Gómez R, Miligkos M, Pitrez PMC, Price D, Pohunek P, Roberts GC, Sheikh A, Tsiligianni I, Turner S, Valiulis A, Winders T, Yusuf OM, Zar H. Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort. Allergy 2021; 76:1765-1775. [PMID: 33608919 PMCID: PMC8013557 DOI: 10.1111/all.14787] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 02/06/2023]
Abstract
Background The interplay between COVID‐19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID‐19 pandemic on childhood asthma outcomes. Methods The PeARL multinational cohort included 1,054 children with asthma and 505 non‐asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID‐19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control. Results During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison with the preceding year. Sixty‐six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre‐bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non‐asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits, or hospitalizations during the pandemic. However, an increased risk of URTIs emerged. Conclusion Childhood asthma outcomes, including control, were improved during the first wave of the COVID‐19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID‐19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.
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