0878 SCREENING OF PEDIATRIC SLEEP-DISORDERED BREATHING WITH A CONTACT-FREE UNDER-THE-MATTRESS SENSOR

Abstract

Introduction: Contact free measurement of sleep and obstructive sleep apnea (OSA) in children may simplify screening, and allow unobtrusive home testing. In this study, a contact‐free system, previously validated for sleep in adults, was tested for its sleep apnea screening capabilities in children. Methods: Children referred to a sleep study with suspected Sleep‐ Disordered Breathing (SDB) underwent full polysomnography in a sleep laboratory, and were simultaneously measured with the contact‐ free system, utilizing a piezo‐electric (PE) sensor placed under the mattress. This PE system (EarlySense, Israel), which has been previously validated for sleep staging in adults, measures parameters, including respiration effort, heart rate and movement. In apnea detection, the system identifies periodic patterns of respiration effort associated with apnea. The system's Apnea‐Hypopnea‐Index (AHI) and sleep/wake detections were compared to polysomnography‐based manual scoring of a blinded expert. Results: Ten children (5 males), ages 1‐13 (5.4 ± 3.6), with BMI of 14‐21 (17.1 ± 2.1), number of apnea/hypopnea events of 0‐21 (9.7 ± 6.0) and AHI of 0‐3 (1.5 ± 0.8) were included. The PE system's sleep/wake accuracy was 84.8%, with some overestimation of wake. Wake sensitivity was 85.0% and sleep sensitivity was 84.8%. Bland Altman analysis for the total number of apnea/hypopnea events, showed a standard deviation of 5.39 with bias of ‐1.65 for the PE system compared with the gold standard. Bland Altman analysis for AHI values, showed a standard deviation of 0.99 with bias of ‐0.07 for the PE system compared with the gold standard. Conclusion: This interim analysis shows promising results for the estimation of SDB in children using a contact‐free under‐the‐mattress system. The wake overestimation may be explained by high activity levels of children, especially in younger ages. This overestimation was not present in adults, which had better sleep/wake accuracy of 89.4%, wake sensitivity of 80.8% and sleep sensitivity of 91.2%. Additional children with higher AHI are being recorded to increase and vary the database, and further work is needed to adjust the sleep algorithm for young children. The PE contact‐free system may be used in the future for effortless screening of children's sleep for several consecutive nights, in their natural home setting.