Feasibility of unattended home polysomnography in children with sleep-disordered breathing

To investigate the technical feasibility of unattended polysomnography (HPSG) for diagnosis of obstructive sleep apnea (OSA) in children.

A single-night HPSG was performed on children referred to the pediatric respiratory laboratory. Non-interpretable HPSGs were defined as: recordings with (i) loss of ≥2 of the following channels: nasal flow, or thoraco-abdominal belts, or (ii) HPSG with less than 4 h of artifact-free recording time or (iii) less than 4 h SpO2 signal.

Of n = 101 included HPSGs, n = 75 were ambulatory and n = 26 in hospitalized subjects. Median (minimum-maximum) age was 2.8 (0-15.4) years. Interpretable and technically acceptable recordings were obtained in 94 subjects (93%). Only 7 recordings (4 at home versus 3 in hospitalized subjects, p-value = 0.254) were classified as non-interpretable and had to be repeated. Artifact-free recording time was 461 (23-766)min. Complete artifact-free pulse oximetry signal was obtained in 14% of the included subjects. Neither age, gender, AHI, nor place of performance was significantly associated with the interpretability of recordings.

HPSG showed a high rate of interpretability and technical acceptance. The high technical feasibility obtained by HPSG may help to improve simple screening tests for OSA in children.