PT  - JOURNAL ARTICLE
AU  - Sandra Chuang
AU  - Arthur Teng
AU  - Jane Butler
AU  - Simon Gandevia
AU  - Hiran Selvadurain
AU  - Adam Jaffe
TI  - CPAP can improve respiratory effort as measured by surface electromyogram of the diaphragm (sEMGdi) in children with sleep-disordered breathing
AID  - 10.1183/13993003.congress-2016.PA4351
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA4351
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA4351.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA4351.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Background: Diaphragmatic surface EMG is a recognised alternative measure of respiratory effort during sleep in children. A reliable method for quantifying sEMGdi has been developed.Aim: To determine whether respiratory effort (as measured by sEMGdi) in children with sleep-disordered breathing can be improved by CPAP.Methods: Children who had split overnight sleep studies ( diagnostic and CPAP titration within one study) were included. Excerpts from random eye movement (REM) and non-REM (NREM) sleep before and after CPAP initiation were exported from the Compumedics Profusion 3 system (Compumedics, Australia) to the Spike2 system (Cambridge Electronics Design, UK) for further analysis. Wilcoxon matched pairs signed-rank test were used to compare the sEMGdi.Results: Split sleep studies from 10 children (8 boys; median age 1.85 years (IQR 0.84-11 years)) were included in this preliminary study. In NREM sleep, sEMGdi improved significant from median 5.83 uV (IQR 2.54-10.2) pre-CPAP to 4.00 uV (1.76-9.2) post CPAP. (p=0.037). In REM sleep, sEMGdi also improved significantly from 10.35uV (4.7-15.13) pre-CPAP to 4.35uV (2.15-6.7) post-CPAP. (p=0.037) Conclusion: Respiratory effort can be improved by CPAP in children with sleep-disordered breathing, especially during REM sleep. Potentially sEMGdi is a useful outcome measure when titrating CPAP in children without OSA.