Validation of the MediByte Portable Monitor for the Diagnosis of Sleep Apnea in Pediatric Patients

Abstract

Study objectives: Polysomnography (PSG) is considered the gold standard in the diagnosis of sleep apnea. In pediatric patients, because of limited availability and access to laboratory-based PSG, there can be significant delays in the diagnosis and management of sleep apnea that can result in progressive associated comorbidities. The main objective of the current study was to test the diagnostic value of a portable sleep monitor (PM), the MediByte, in comparison with laboratory PSG in pediatric patients wearing both setups simultaneously.

Methods: A consecutive series of pediatric patients referred to the University of Illinois Sleep Science Center wore the MediByte during simultaneous PSG. The apnea-hypopnea index (AHI) was calculated for PSG and both manual and autoscoring functions of the PM. Pearson correlation and Bland-Altman plots were assessed.

Results: A total of 70 patients successfully completed simultaneous PSG and PM studies (median age 10.8 years). The AHI obtained both manually and automatically scored PM studies strongly correlated with the AHI obtained from the PSG (r ≥ .932, P < .001). The oxygen saturation obtained by the PM showed significant correlation with that obtained by PSG among children aged 12 to 17 years (P < .001), but not among children aged 7 to 11 years (P ≥ .24). The sensitivity and specificity for detection of severe sleep apnea diagnosed by PSG (AHI ≥ 10 events/h) using both PM scoring methods was very high (> 93% for both).

Conclusions: Although PSG is still recommended for the diagnosis of sleep apnea, PMs can play a valuable role in diagnosing moderate and severe sleep apnea, especially in older pediatric patients.

Commentary: A commentary on this article appears in this issue on page 685.

Keywords: HST; MediByte; children; polysomnography; portable monitoring; sleep; sleep apnea.

© 2019 American Academy of Sleep Medicine.

Figures

Figure 1

Pearson correlation between the apnea-hypopnea index from the polysomnography (AHI PSG) and the portable monitor scored automatically (PMa; left), automatically with bad data excluded (PMax; middle), and manually (PMm; right).

Figure 2

Apnea-hypopnea index (AHI) Bland-Altman analysis for portable monitor scored automatically (PMa; left), automatically with bad data excluded (PMax; middle), and manually (PMm; right). PSG = polysomnography

Figure 3

Apnea-hypopnea index (AHI) corrected Bland-Altman analysis after excluding AHI > 22 events/h for portable monitor scored automatically (PMa; left), automatically with bad data excluded (PMax; middle), and manually (PMm; right). PSG = polysomnography.