DOCUMENTED HOME APNEA MONITORING - EFFECT ON COMPLIANCE, DURATION OF MONITORING, AND VALIDATION OF ALARM REPORTING

The objectives of this study were to: (1) measure patient compliance w ith monitoring, (2) validate par-ental reports of alarms at home, (3) examine monitoring duration, and (4) compare documented monitor record s with the traditional pneumogram to evaluate patients for monitor dis continuation, During the 1-year period from January through December, 1992, 114 infants were followed up with documented monitoring. Simulta neously, 113 infants were followed up with conventional monitors. Infa nts were premature, or victims of apparent life-threatening episodes ( ALTE), or siblings of SIDS victims, Monitors recorded all episodes of apnea greater than 15 seconds and bradycardia less than 80 beats per m inute, All families were contacted biweekly by telephone. Downloads we re performed at regular intervals. Monitor downloads were compared wit h simultaneous pneumograms to assess the accuracy of a long-term, inte rmittent event-recording system versus short-term (6- to 12-hour) cont inuous recording. All families were highly compliant with the use of h ome monitoring. Although Caucasian families used the monitors more oft en than non-Caucasian families, all groups used the monitor > 75% of t he time, True episodes were verified in 38% of patients by monitor dow nloads. Only 7.4% of all recorded events were true events. Of the real events, 51.2% were apneas of 16-20 seconds. No significant difference s were found in overall duration of monitoring between documented and nondocumented monitors. In the premature infants, the duration of moni toring was significantly reduced in those infants found to have no tru e episodes over those with. real events at home. Readmission for ALTE was reduced in infants with documented monitors. Premature infants wit hout events were monitored an average of 24 fewer days (P = 0.03), Com puterized monitor downloads were found to be equally, if not more, sen sitive than pneumograms in evaluating infants for monitor discontinuat ion. Documented monitoring offers a viable alter-native to traditional monitoring and pneumograms in assisting clinicians and families in ev aluating their infant's progress. By accurately assessing compliance, distinguishing true from false alarms, and decreasing the need for pne umograms, these devices provide valuable information to clinicians and families.