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Updated: Apr 25, 2026
Multi-Modal Home Sleep Monitoring in Older Adults
Published on: January 26, 2019
Feasibility of comprehensive, unattended ambulatory polysomnography in school-aged children
Carole L Marcus1, Joel Traylor1, Sarah N Biggs2
1Department of Pediatrics, Sleep Center, Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, PA;
Insights
Unattended ambulatory polysomnography (PSG) is feasible and well-tolerated in school-aged children, providing technically adequate sleep data. This comprehensive home-based study demonstrates high satisfaction rates among participants and parents.
Area of Science:
- Pediatric Sleep Medicine
- Clinical Neurophysiology
- Ambulatory Monitoring
Background:
- Ambulatory polysomnography (PSG) is common in adults but less studied in children.
- Few studies have assessed comprehensive PSG, including electroencephalography (EEG), in pediatric home environments.
Purpose of the Study:
- To evaluate the feasibility of unattended ambulatory PSG in school-aged children.
- To assess the technical adequacy and tolerability of home-based PSG in this population.
Main Methods:
- 201 children (aged 5-12 years), born premature (500-1,250g), underwent unattended ambulatory PSG.
- The study was conducted internationally in Canada and Australia.
- Data included electroencephalography, airflow, and other standard PSG parameters.
Main Results:
- Overall technical success rate was 98% after repeat studies.
- High-quality, artifact-free signals were achieved for most parameters in over 92% of subjects.
- Children exhibited good sleep quality (high efficiency, low arousal index) and high satisfaction.
Conclusions:
- Comprehensive unattended ambulatory PSG is feasible, technically adequate, and well-tolerated in school-aged children under research conditions.
- Further research into cost-effectiveness and clinical generalizability is recommended.
Study Objectives:
Although unattended ambulatory polysomnography (PSG) is frequently performed in adults, few studies have been performed in children. The objective of this study was to evaluate the feasibility of comprehensive, ambulatory PSG, including electroencephalography, in school-aged children in the home environment.
Methods:
A total of 201 children, born premature with birth weights of 500-1,250 grams, currently aged 5-12 years and living in Canada and Australia, underwent unattended ambulatory PSG.
Results:
PSG was initially technically satisfactory in 183 (91%) cases. Fourteen studies were satisfactory when repeated, resulting in an overall satisfactory rate of 197 (98%). Artifact-free signals were obtained for ≥ 75% of recording time in more than 92% of subjects, with the exception of nasal pressure, which was satisfactory for ≥ 75% of recording time in only 67% of subjects. However, thermistry signals were satisfactory for ≥ 75% of recording time in 92% of subjects, and some measure of airflow was present for ≥ 75% of recording time in 96% of subjects. Children slept very well, with a long total sleep time (534 ± 73 [mean ± SD] minutes), high sleep efficiency (92% ± 5%), and low arousal index (9 ± 3/h). Parents and children reported a high rate of satisfaction with the study.
Conclusions:
This large, international study has shown that comprehensive, unattended, ambulatory PSG is feasible, technically adequate and well-tolerated in school-aged children when performed under research conditions. Further studies regarding the cost efficacy of this approach, and generalizability of the findings to a clinical population, are warranted.
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