Home Polysomnography in Children With Autism Spectrum Disorder: A Prospective Observational Study

This prospective observational study reports on the feasibility and adequacy of Level 2 polysomnography involving children with autism spectrum disorder during an interventional-randomised controlled trial. Multiple level 2 polysomnographic studies were performed using Nox-A1 devices worn between October 2023 and September 2024. Study feasibility was determined by the child's compliance and primary caregiver report, while signal quality (key channels present for at least 90% of sleep time) was used to define study adequacy. A cost analysis was also conducted. Twenty children (6-12 years, 9.1 + 1.55 years; 16 males) with autism spectrum disorder (level 2) and reported sleep difficulties participated in the study. Eighty (89%) of 90 polysomnographic studies were feasible. All infeasible studies, except one, were unrelated to the study. Seventy-four (93%) of the eighty studies resulted in adequate study quality. Most (n = 6, 7%) inadequate studies were due to electroencephalogram signal artefact/absence. The participants did not have a sleep disorder requiring medical attention. The cost of a study was estimated at $AUD 258. The study indicates the feasibility, adequacy, and cost-effectiveness of level 2 polysomnography in evaluating sleep outcomes in children with autism spectrum disorder during an interventional randomised controlled trial. This preliminary study provides valuable insights into the field of paediatric sleep medicine. Repeat studies of this method using diverse and larger sample sizes are warranted.