Background

Polysomnography (PSG) is the gold standard for the diagnosis of obstructive sleep apnea (OSA) and its follow-up after treatment in children. Recently, a very innovative digital medicine solution with a mandibular movement sensor has been developed. In children, a good correlation between mandibular movements and the apnoea hypopnoea index (AHI) has been reported (Martinot et al., Pediatr Pulmonol, 2022).

Objective

The main aim of this study was to assess the reliability of mandibular movement measurement by a sensor for the assessment of residual obstructive airway events in children with OSA ventilated with noninvasive ventilatory support.

Methods

We conducted an open prospective non randomised multicentric trial. We included children aged 5 to 18 years with a diagnosis of severe OSA diagnosed during a PSG, defined by an AHI ? 10/hours or an apnea index ? 5/hours, and ventilated.  Differences in continuous variables were assessed by Wilcoxon signed rank test.

Preliminary results

Twelve children were included with a median age of 12 years [IQR 9,5-15,5], 25% were females. Two (17%) children were ventilated with noninvasive ventilation and 10 (83%) with continuous positive airway pressure. The Total sleep time was 471 minutes [IQR 441-506] during the recording with both PSG and sensor. Comparison of the hourly respiratory disturbance index (RDI) (obstructive apnoeas, hypopnoeas and respiratory effort arousals) during PSG (PSG_RDI) and Sleep Disorder Aid Diagnosis called SUNRISE-RDI (Sr_RDI) was similar, p=0.30).

In conclusion, automated analysis of mandibular movement is a reliable method to assess residual obstructive airway events in a population of ventilated children.