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Sleep Studies in Children
Ankit Parakh1, Dhulika Dhingra2, Francois Abel3
1Department of Pediatric Pulmonology and Sleep Medicine, BLK Max Memorial Hospital, New Delhi, India. Correspondence to: Dr Ankit Parakh, Senior Consultant, Pediatric Pulmonology and Sleep Medicine, Center for Child Health, BL Max Hospital, New Delhi. ankitparakh102@gmail.com.
Insights
Sleep-related breathing disorders (SRBD) in children are common and diagnosed using methods like polysomnography (PSG) and respiratory polygraphy. This review discusses various diagnostic approaches for SRBD in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Respiratory Physiology
Background:
- Sleep-related breathing disorders (SRBD), or sleep-disordered breathing (SDB), are prevalent in children.
- SRBD are categorized as central or obstructive, often linked to adenotonsillar hypertrophy (simple) or underlying conditions like obesity (complex).
- Accurate diagnosis is crucial for effective management of pediatric sleep disorders.
Purpose of the Study:
- To review and compare various diagnostic methods for assessing sleep-related breathing disorders in children.
- To highlight the utility and limitations of different diagnostic tools.
- To guide clinicians in selecting appropriate diagnostic strategies for pediatric SRBD.
Main Methods:
- Discussion of polysomnography (PSG) as the gold standard for diagnosing sleep disorders.
- Evaluation of attended in-lab respiratory polygraphies as a practical alternative to PSG.
- Assessment of overnight unattended home respiratory polygraphies and overnight oximetry for screening and diagnosis.
- Emphasis on patient selection and parental education for home-based studies.
Main Results:
- Polysomnography (PSG) provides comprehensive sleep data but is resource-intensive.
- Attended respiratory polygraphies offer comparable respiratory data to PSG with greater ease of conduct.
- Home-based respiratory polygraphies and oximetry are increasingly utilized, requiring careful implementation.
- Overnight oximetry serves as a valuable screening tool for obstructive sleep apnea in children.
Conclusions:
- Various diagnostic modalities exist for pediatric SRBD, each with specific advantages and limitations.
- The choice of diagnostic method should be tailored to the clinical context, considering factors like disorder complexity and resource availability.
- Effective use of home-based monitoring requires careful patient selection and robust parental education programs.
Abstract:
Sleep-related breathing disorders (SRBD), also referred to as sleep-disordered breathing (SDB), are common sleep disorders in children. They can be broadly divided between central and obstructive sleep-disordered breathing with or without associated hypoventilation. In most cases, SRBD are associated with adenotonsillar hypertrophy (obstructive SDB) which are classified as simple. SRBD can co-exist with an underlying condition like obesity, genetic syndromes or neuromuscular disorders which are classified as complex. Polysomnography (PSG) is the gold standard for diagnosing sleep disorders. However, it is time-consuming and requires trained technician to acquire and interpret signals. Attended in-lab respiratory polygraphies are easier to conduct and provide respiratory data equivalent to a PSG. Similar to adult sleep services, overnight unattended home respiratory polygraphies are becoming more widely used. These require careful patient selection and good parental education programs to be most successful in children. Overnight oximetry has limitations but can be a useful tool for screening children with obstructive sleep apnea and prioritizing treatment. This review aims to discuss these various diagnostic methods to assess sleep disorders in children.
