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Sleep medicine: pediatric polysomnography revisited
David N Cornfield1, Sumit Bhargava
1Center for Excellence in Pulmonary Biology, Divisions of Pulmonary, Asthma and Sleep Medicine, Department of Pediatrics, Stanford University Medical School, Stanford, California, USA.
Current Opinion in Pediatrics
|May 7, 2015
Summary
Polysomnography (PSG) testing for sleep-disordered breathing in children needs reassessment. Rationalizing PSG use can reduce costs and anxiety without impacting care quality for pediatric sleep apnea.
Area of Science:
- Pediatric Sleep Medicine
- Sleep-Disordered Breathing Diagnostics
- Clinical Utility Assessment
Background:
- Sleep medicine is a growing pediatric subspecialty.
- The clinical utility of polysomnography (PSG) for sleep-disordered breathing remains uncertain.
- High costs and inconvenience associated with PSG testing necessitate re-evaluation.
Purpose of the Study:
- To critically assess the clinical utility of polysomnography (PSG) in pediatric sleep medicine.
- To propose a framework for rationalizing PSG testing for sleep-disordered breathing.
- To address the cost-effectiveness and patient experience of PSG.
Main Methods:
- The study advocates for using clinically significant endpoints.
- Emphasis is placed on readily available parental data.
- Data from randomized, placebo-controlled trials are recommended for evaluating PSG in obstructive sleep apnea.
Main Results:
- The current approach to PSG testing warrants reassessment due to uncertain clinical impact.
- A rationalized approach to PSG can mitigate costs and inconvenience.
- Parental anxiety associated with PSG testing can be reduced.
Conclusions:
- Rationalizing polysomnography (PSG) use in pediatric sleep medicine is crucial.
- Implementing evidence-based approaches can decrease costs and parental anxiety.
- Care quality can be maintained while optimizing PSG testing protocols.
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