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Suspected pediatric sleep disordered breathing - when do we perform polysomnography?

Ella Ruikka1,2, Lotta Ukonaho3, Ilkka Kivekäs4,3

  • 1Department of Otorhinolaryngology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Elämänaukio 2, Tampere, 33520, Finland. ella.ruikka@tuni.fi.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|May 29, 2025
PubMed
Summary

Referrals for polysomnography (PSG) in children with suspected sleep disordered breathing (SDB) are influenced by age, sex, symptoms, and referral source. Developing a standardized guideline for PSG referral is crucial for consistent diagnosis and treatment.

Keywords:
Adenotonsillar hypertrophyObstructive sleep apneaPediatricPolysomnographySleep disordered breathing

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Area of Science:

  • Pediatrics
  • Sleep Medicine
  • Respiratory Medicine

Background:

  • Diagnosing pediatric sleep disordered breathing (SDB) often requires polysomnography (PSG), a resource-intensive procedure.
  • Clinical assessment for SDB in children can be unreliable, necessitating objective diagnostic methods.
  • Factors influencing the decision for PSG referral in pediatric SDB require identification.

Purpose of the Study:

  • To identify factors influencing the decision to refer children with suspected SDB for polysomnography (PSG).
  • To understand the variability in PSG referral practices for pediatric SDB.

Main Methods:

  • Retrospective cohort study involving 1267 children aged 0-16 years with suspected SDB.
  • Analysis of factors associated with PSG referral, including age, sex, symptoms, comorbidities, and referral source.

Main Results:

  • PSG was performed in 16.5% of children.
  • Referral for PSG increased with age, male sex, and specific obstructive sleep apnea (OSA) symptoms.
  • Children with moderate/severe comorbidities and those referred from pediatric specialties had higher PSG referral rates.
  • Referrals from dentists were associated with lower PSG likelihood.

Conclusions:

  • The decision to refer children for PSG is subjective and influenced by multiple factors.
  • A standardized guideline for PSG referral in pediatric SDB is needed to ensure consistent diagnosis.
  • Standardized referral pathways can optimize diagnostic procedures and treatment planning for SDB.