BackgroundThe polysomnography (PSG) is the gold‐standard for obstructive sleep apnea (OSA) syndrome diagnosis and assessment under positive airway pressure (PAP) therapies in children. Recently, an innovative digital medicine solution, including a mandibular jaw movement (MJM) sensor coupled with automated analysis, has been validated as an alternative to PSG for pediatric application.ObjectiveThis study aimed to assess the reliability of MJM automated analysis for the assessment of residual apnea/hypopnea events during sleep in children with OSA treated with noninvasive ventilation (NIV) or continuous PAP (CPAP).MethodsIn this open‐label prospective non‐randomized multicentric trial, we included children aged from 5 to 18 years with a diagnosis of severe OSA. The children underwent in‐laboratory PSG with simultaneous MJM monitoring and at‐home recording with MJM monitoring 3 months later. Agreement between PSG and MJM analysis in measuring the residual apnea‐hypopnea index (AHI) was evaluated by the Bland−Altman method. The treatment effect on residual AHI was estimated for both PSG and MJM analysis.ResultsFifteen (60% males) children were included with a median age of 12 years [interquartile range 8−15]. Two (17%) were ventilated with NIV and 13 (83%) with CPAP. There was a good agreement between MJM‐AHI and PSG‐AHI with a median bias of −0.25 (95% CI: −3.40 to +2.04) events/h. The reduction in AHI under treatment was consistently significant across the three measurement methods: in‐laboratory PSG and MJM recordings in the laboratory and at home.ConclusionAutomated analysis of MJM is a highly reliable alternative method to assess residual events in a small population treated with PAP therapies.

中文翻译：

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分析下颌运动以评估接受气道正压治疗的阻塞性睡眠呼吸暂停综合征儿童的通气支持管理

背景多导睡眠图（PSG）是儿童气道正压通气（PAP）治疗下阻塞性睡眠呼吸暂停（OSA）综合征诊断和评估的金标准。最近，一种创新的数字医学解决方案，包括下颌运动 (MJM) 传感器与自动分析相结合，已被验证为儿科应用中 PSG 的替代方案。 目的本研究旨在评估 MJM 自动分析在评估残余下颌骨中的可靠性。接受无创通气 (NIV) 或连续 PAP (CPAP) 治疗的 OSA 儿童在睡眠期间出现呼吸暂停/呼吸不足事件。 方法 在这项开放标签前瞻性非随机多中心试验中，我们纳入了 5 至 18 岁、诊断为重度呼吸暂停的儿童。 OSA。这些儿童在 3 个月后接受了实验室 PSG 和同步 MJM 监测，并在家里进行了 MJM 监测和记录。通过 Bland-Altman 方法评估 PSG 和 MJM 分析在测量残余呼吸暂停低通气指数 (AHI) 方面的一致性。通过 PSG 和 MJM 分析估计对残余 AHI 的治疗效果。结果 纳入 15 名儿童（60% 男性），中位年龄为 12 岁[四分位数范围 8−15]。 2 名 (17%) 患者使用 NIV 通气，13 名患者 (83%) 使用 CPAP 通气。 MJM-AHI 和 PSG-AHI 之间具有良好的一致性，中位偏差为 -0.25 个事件/小时（95% CI：-3.40 至 +2.04）个事件/小时。在三种测量方法中，治疗中 AHI 的减少始终显着：实验室内 PSG 和实验室和家中的 MJM 记录。结论 MJM 的自动分析是一种高度可靠的替代方法，用于评估接受 PAP 治疗的小群体中的残留事件疗法。