ORIGINAL RESEARCH article
Front. Neurol.
Sec. Sleep Disorders
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1632919
This article is part of the Research TopicNovel technologies in the diagnosis and management of sleep-disordered breathing: Volume IIIView all 14 articles
Pulse Transit Time Respiratory Swing as a Diagnostic Test for Obstructive Sleep Apnoea in Children - An Observational Study
Provisionally accepted
- 1Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, United Kingdom
- 2Post University, Waterbury, United States
- 3University of Nottingham, Nottingham, United Kingdom
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Pulse transit time (PTT) was identified as a potentially useful tool for diagnosing obstructive sleep apnoea (OSA) because it detects cortical arousals with high sensitivity. However, its use in clinical practice has been disappointing because it appears to lack the ability to discriminate between individuals with or without OSA. Most studies evaluating PTT for sleep disordered breathing (SDB) have assessed the arousal index (PTT-AI) and there is limited published data on PTT Respiratory swing (PTTrs). We previously conducted an observational study of PTT in 368 children with SDB, and found that depending on the cut-off used, PTTrs identified OSA with low-moderate sensitivity and moderate-high specificity, using a limited multi-channel sleep study (MCSS) as the comparator. We have undertaken this cross-sectional observational study in another cohort of 1031 children with SDB who attended a secondary care centre consecutively for MCSS between July 2022 and November 2024. Polysomnography (PSG) is not available in UK secondary care centres and our use of MCSS in this setting is novel. We analysed the data of 629 children using multinomial regression and machine learning. We found a stepwise increase in PTTrs with increasing severity of SDB. Children with mild OSA had a mean PTTrs of 20.7ms. Machine learning analysis showed that the oxygen desaturation index (ODI3) and PTTrs were the most important predictors of SDB out of 15 variables studied. Our findings suggest that PTTrs could complement oximetry to improve the detection of OSA in children. A validation study comparing PTTrs with PSG is needed.
Keywords: Pulse Transit Time, Sleep disordered breathing, obstructive sleep apnoea, Upper airway resistance syndrome, Oximetry, Children, machine learning
Received: 21 May 2025; Accepted: 20 Aug 2025.
Copyright: © 2025 Yanney, Essiam, Rowbotham and Prayle. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Andrew P Prayle, University of Nottingham, Nottingham, United Kingdom
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