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Published on: October 2, 2019
Evaluation of the validity of psychological preparation for children undergoing polysomnography
Emi Murata1, Kumi Kato-Nishimura2, Masako Taniike1,2
1United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka, Japan.
Insights
Psychological preparation significantly improves the success rate of polysomnography (PSG) for children, especially those with autism spectrum disorder (ASD), reducing the need for sedatives.
Area of Science:
- Pediatric Sleep Medicine
- Neurodevelopmental Disorders
Background:
- Nocturnal polysomnography (PSG) is crucial for diagnosing sleep disorders like sleep-disordered breathing (SDB).
- Conducting PSG with uncooperative children, particularly those with autism spectrum disorder (ASD), presents significant challenges due to anxiety and communication difficulties.
Purpose of the Study:
- To evaluate the effectiveness of psychological preparation in facilitating polysomnography (PSG) for children.
- To assess if psychological preparation reduces the need for sedative medications during PSG.
Main Methods:
- A study involving 253 children, with 131 in a control group and 122 in a group receiving psychological preparation.
- The preparation group included 51 children with ASD, while the control group had 19 children with ASD.
Main Results:
- 90.2% of children in the preparation group successfully underwent PSG, compared to 79.4% in the control group (P = .018).
- 91.0% of the preparation group completed PSG without hypnotic drugs, versus 81.7% in the control group (P = .032).
- 88.2% of children with ASD in the preparation group underwent PSG without sedatives.
Conclusions:
- Psychological preparation is an effective strategy for improving PSG completion rates in children.
- This method is particularly beneficial for children with ASD and those who struggle with cooperation during sleep studies, minimizing the need for sedatives.
Study Objectives:
Nocturnal polysomnography (PSG) is an essential diagnostic technique to assess sleep abnormalities, including sleep-disordered breathing (SDB). Although low in invasiveness, it is extremely difficult to conduct PSG with children who are not cooperative with wearing electrodes and sensors. Particularly, it is difficult to conduct PSG on children with autism spectrum disorder (ASD) because they have poor predictive ability, exhibit extreme anxiety about novel and unfamiliar things, and have difficulty understanding verbal instructions. Recently, the usefulness of psychological preparation was reported. The primary aim of this study was to assess the usefulness of psychological preparation for PSG.
Methods:
The goal of our study was to assess the usefulness of psychological preparation for PSG. A total of 253 children were enrolled in the study: 131 in the control group (19 with ASD) and 122 selected for psychological preparation (51 with ASD).
Results:
In the preparation group, 110 of 122 (90.2%) could undergo regular PSG, a significantly higher percentage than the control group at 104 of 131 (79.4%), P = .018. Regarding hypnotic drugs, in the preparation group 111 of 122 (91.0%) underwent PSG without hypnotic drugs, which was a significantly higher percentage than in the control group at 107 of 131 (81.7%), P = .032. Additionally, 45 of 51 children with ASD in the preparation group (88.2%) could undergo PSG without hypnotic drugs.
Conclusions:
This study indicated that psychological preparation was effective in facilitating PSG without hypnotic drugs in children who have difficulty cooperating with PSG, including those with ASD.
