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Sweet dreams at home: A review of paediatric domiciliary sleep studies

Jade Grillo1, Danny J Eckert2, Selina Shivji1

  • 1College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, South Australia, Australia.

Sleep Medicine
|April 22, 2026
PubMed

Insights

Home sleep apnea testing in children shows promise for timely diagnosis of sleep-disordered breathing (SDB). Further validation is needed to improve accuracy and overcome implementation challenges for better pediatric care.

Area of Science:

  • Pediatric Sleep Medicine
  • Diagnostic Technology Evaluation

Background:

  • In-laboratory polysomnography is the gold standard for diagnosing pediatric sleep-disordered breathing (SDB) and obstructive sleep apnea (OSA).
  • Current diagnostic methods face barriers like long waitlists, limited accessibility, and burdensome hospital stays, hindering timely diagnosis.
  • Domiciliary sleep studies, widely used in adults, have limited adoption in pediatrics due to a lack of validation and standardization.

Purpose of the Study:

  • To review the current evidence for domiciliary sleep studies in children for diagnosing SDB and OSA.
  • To highlight the potential of home-based sleep studies to improve timely diagnosis and management.
  • To identify areas for improvement in pediatric domiciliary sleep diagnostics.

Main Methods:

  • A structured MEDLINE search identified 16 key articles on home-based diagnostic methods.
  • Methods reviewed included polysomnography, pulse oximetry, transcutaneous CO2 monitoring, and novel limited-channel commercial devices.
  • Articles were analyzed for feasibility, parental preference, diagnostic accuracy, and implementation challenges.

Main Results:

  • Home-based polysomnography (Level 2) demonstrates high feasibility and parental preference.
  • Simpler modalities like pulse oximetry and Level 4 approaches may underdiagnose OSA due to limited apnoea detection.
  • Commercial devices, while better tolerated, often have reduced diagnostic accuracy, particularly for apnoea-hypopnoea index measurement.

Conclusions:

  • Parental compliance, device accuracy, and implementation challenges are critical themes for domiciliary sleep studies.
  • Recommendations include multi-night testing, simplified equipment, trained technician involvement or thorough parental education, and refined device sensitivity.
  • Further pediatric-specific validation of home-based sleep study technologies is essential to optimize diagnostics and improve clinical outcomes for children with sleep disorders.
Abstract

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