Pediatric Obstructive Sleep-Disordered Breathing: Updated Polysomnography Practice Patterns.

Area of Science:

• Pediatric Otolaryngology
• Sleep Medicine
• Clinical Practice Guidelines

Background:

• Obstructive sleep-disordered breathing is a common condition in children.
• Clinical practice guidelines for polysomnography prior to tonsillectomy were published in 2011.
• Adherence to these guidelines may vary among practitioners.

Purpose of the Study:

• To assess current practice patterns of pediatric otolaryngologists in managing obstructive sleep-disordered breathing.
• To evaluate adherence to polysomnography guidelines for pediatric tonsillectomy.

Main Methods:

• A cross-sectional electronic survey was distributed to members of the American Society of Pediatric Otolaryngology (ASPO).
• The survey assessed the frequency of polysomnogram use and inpatient admission practices.
• 170 (40%) ASPO members completed the survey.

Main Results:

• Only 55% of respondents used polysomnography in 90% of Down syndrome cases, 41% for children <2 years, and 29% for obese children.
• Inpatient admission rates for children with obstructive sleep apnea on polysomnogram were followed by only 37% of respondents.
• Practice patterns were not fully aligned with established clinical guidelines.

Conclusions:

• Current polysomnography practice patterns in pediatric otolaryngology are not aligned with clinical guidelines.
• The threshold for overnight observation may require re-evaluation.
• Further education and evidence are needed to define best practices for managing pediatric obstructive sleep-disordered breathing.