ECG-Derived Respiratory Power Index to Evaluate and Track Pediatric Sleep Apnea

Pediatric obstructive sleep apnea (OSA) is characterized by apneic events, typically quantified using the apneahypopnea index (AHI). Due to limitations of the standard diagnostic test, overnight polysomnography, alternative methods are studied. This study assesses the Respiratory Power Index (RPI) in pediatric OSA, a surrogate AHI measure obtained from electrocardiogram-derived respiration signals. An exploratory analysis was conducted on the non-randomized group (654 children, grouped by OSA severity) from the Childhood Adenotonsillectomy Trial dataset to evaluate RPI changes with disease severity. Additionally, the RPI potential to monitor treatment response from baseline to follow-up group (332 children) was investigated. RPI effectively distinguished OSA severity groups and correlated positively with OSA severity indices. Moreover, RPI differentiated between children at baseline and follow-up, with changes attributable to alterations in OSArelated variables that includes both obstructive and central apneic events. These findings underscore the utility of RPI in pediatric OSA, enabling differentiation of severity groups and monitoring treatment response.