Sleep related breathing disorders in childhood are increasingly recognised as contributors to morbidity as well as suboptimal physical, mental and social development. The associated cost in social and economic terms is clearly significant. Detection and diagnosis of such disorders can be costly and technically difficult. Multi-parameter monitoring like polysomnography is expensive and inappropriate for mass screening or investigations remote from tertiary centres. A simple and non-invasive cardiovascular approach termed pulse transit time (PTT) is useful in determining the status of upper airways during sleep. This approach employs the measurement of the time delay in the arterial pulse pressure wave from the aortic valve of the heart to a peripheral site. PTT has shown promise to provide quantify inspiratory effort in adults with sleep disordered breathing (SDB) and can then be an effective monitoring tool in children. Initial investigations explore the parameters that can confound the PTT measurements of a child. This work provides an estimate of the expected PTT ranges from infancy to childhood. Thereafter, overnight PTT recordings were performed in conjunction with PSG studies to corroborate evidence for its capability in paediatric respiratory studies. The results show that PTT has the ability to identify abnormal respiratory events during sleep. Furthermore, the use of PTT can differentiate the nature of respiratory events as obstructive or central. Technological considerations to improve the robustness of PTT measure to be used not only in cardiorespiratory but also cardiovascular studies on children were also illustrated. Preliminary findings obtained here suggest that the properties of PTT show promise as a predictor for obstructive sleep apnoea. There is a need to bridge the gap of providing quality SDB diagnosis and yet accommodating requirements for a robust screening measure. PTT has demonstrated its suitability and utility as a measure to play a role in the investigation and monitoring of treatment in this area.
| Identifer | oai:union.ndltd.org:ADTP/253645 |
| Creators | Foo, Jong Yong Abdiel |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
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