Making polysomnography more "child friendly:" a family-centered care approach

With the increasing recognition of pediatric sleep disorders, there is a growing demand for pediatric sleep medicine services, including polysomnography. The procedure of polysomnography can be particularly challenging in young children with limited ability to cooperate, especially when they have developmental disabilities or other medical complications. This article describes a family-centered care approach to polysomnography in children that is appropriate in any type of sleep laboratory setting. This approach emphasizes respect for the family, psychological preparation, adaptation of laboratory routines to the needs of the family, substitution of child-friendly terminology for medical jargon, coping strategies for the child and family during the procedure, positioning for comfort, utilization of distraction and medical play, modeling behavior for the parent, and continuous praise and reassurance for the child. In our experience with over 1000 studies in children of all ages with a broad range of comorbidities, implementation of this approach has minimized the burden of the polysomnography for the child, boosted the confidence of the sleep technologist, improved study quality for the diagnostician, and increased patient and family satisfaction.