Introduction
Overnight home pulse oximetry is a cost effective first line investigation in children with sleep-disordered breathing (SDB). However, optimum nights of monitoring needed is unknown.
Aim
To compare between night variability of pulse oximetry in children referred with SDB
Methods
Home oximetry studies on children referred to a paediatric respiratory department with SBD from 3/2/2021-6/5/2022 using Massimo RadŽ were reviewed. Studies with <4 hours consecutive data on <2 nights were excluded. Data on mean oxygen saturation (SpO2), time spent SpO2? 90%, time spent SpO2? 92%, oxygen desaturation index (ODI) >4/hour(h) (ODI4) and ODI >3/h (ODI3) were compared between the 2 nights.
Results
Of 132 studies, 27 were excluded; test failure (n=10 (7.6%)) and <2 nights recorded (n=17). Children (n=105, male n=67, female n=38) aged median 5.4 (interquartile range (IQR) 5.7) years had 2 nights with a mean time of data collection of 9.25 (IQR 2.3) h/ night. Clinically significant between night variability was defined as a difference in mean SpO2>3%, ODI3>2/h, ODI4>2/h and time spent SpO2?90% and SpO2?92% of ?2%. Non-parametric tests show that all 5 variables are equivalent between night 1 and night 2 in this cohort (see table).*
Conclusion
Pulse oximetry has a low failure rate (7.6%) and no clinically significant between-night variability. One night of oximetry monitoring is sufficient in most patients to screen for SDB.
Table: Pulse oximetry measurements median (IQR)
| Night 1 | Night 2 | |
| Mean SpO2 | 97.8(1.4)% | 97.6(1.3)% |
| Time SpO2?92% | 0.03(0.14)% | 0.06(0.29)% |
| Time SpO2?90% | 0.01(0.05)% | 0.01(0.07)% |
| ODI4/h | 2.1(3.1) | 1.7(2.8) |
| ODI3/h | 4.4(4.8) | 3.6(4.5) |
*Reference: Dinno 2017, Two one-sided tests for equivalence