Use of peripheral arterial tonometry in pediatric sleep assessment: A scoping review

Peripheral arterial tonometry (PAT) is a novel technology that has been used for assessment of sleep in children. This scoping review aimed to explore the literature regarding PAT use in pediatric sleep assessment, highlighting gaps and offering potential avenues for future research.

MEDLINE, Embase, Emcare, Scopus and grey literature were searched to identify studies using PAT for the assessment of sleep in children (including but not limited to: sleep stages, sleep-disordered breathing (SDB) and validation studies against polysomnography (PSG)). The protocol was published prospectively in OSF (DOI:10.17605/OSF.IO/39N68).

Sixty-three studies (15 primary (including three abstracts) and 48 non-primary papers) were included. Primary papers included between 1 and 169 participants aged 4-18 years. Nine primary studies included a comparator method of sleep assessment, including eight that used PSG. Two studies evaluated the association between SDB and atopy, while four analysed non-SDB aspects of sleep. The two studies that reported PAT-derived sleep states demonstrated inconsistencies between PAT and PSG. Five studies (including two in abstract only) validated PAT against PSG in the detection of obstructive respiratory events, with inconsistent conclusions. Only seven original studies were cited by the 48 non-primary papers.

Despite many review papers mentioning PAT for use in pediatric sleep assessment, little primary research exists, with inconsistent results in the assessment of SDB. Further rigorous studies are needed to determine the accuracy of PAT technology in the assessment of SDB and sleep more broadly, before its place in pediatric research and clinical practice can be determined.