Reference values for nocturnal home pulse oximetry during sleep in primary school children

Objective: To provide reference values for pulse oximeter saturation (SpO(2)) in primary school children, measured at home during sleep. Methods: Recordings of SpO(2) and signal quality from 100 children were randomly selected from a larger population-based sample intended to study the prevalence of sleep-disordered breathing. Recordings were analyzed for the duration of artifact-free recording time (AFRT), minimum SpO(2) (SATmin) and median SpO(2) (SAT(50)), the SpO(2) below which the child spent 5% of AFRT (SAT(5)), and the SpO(2) below which the child spent 10% of AFRT (SAT(10)). In addition, the time in seconds with SpO(2) less than or equal to 90% per hour of AFRT (TI90) was calculated, as were the number of falls in SpO(2) by greater than or equal to 4 % per hour of AFRT (DI4), the number of falls in SpO(2) to less than or equal to 90% per hour of AFRT (DI90), and the number of falls in SpO(2) to less than or equal to 92% per hour of AFRT (DI92). Results: Ten recordings had to be excluded because of insufficient AFRT (< 5 h). Mean age of the remaining 90 children (54 girls) was 9.3 years (SD, 0.6). Median (range; fifth centile) values for SATmin, SAT(5), SAT(10), and SAT(50) were 93% (76 to 97; 87.5),97% (88 to 99; 95),97% (89 to 99; 96), and 98% (94 to 100; 97). Median values (range; 95th centile) for TI90, DI4, DI90, and DI92 were 0.0 s (0.0 to 5.8; 1.6), 0.8 (0.0 to 6.1; 3.9), 0.0 (0.0 to 1.2; 0.2), and 0.0 (0.0 to 2.0; 0.6). Conclusion: Baseline SpO(2) values < 97% were uncommon in these children, as were intermittent desaturations to less than or equal to 90%. These data may serve as a basis for the interpretation of clinical recordings Of SpO(2) in children referred for sleep-related breathing disorders.