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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

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Racial and Ethnic Disparities in Care for Pediatric Sleep-Disordered Breathing.

Colleen C McLaughlin¹, Jesse L Hawke¹, Emily F Boss²

¹Center for Child Health Equity and Outcomes Research, Abigail Wexner Research Institute at Nationwide Children's Hospital Columbus Ohio USA.

|June 8, 2026

Summary

Racial and ethnic minorities, along with urban children, show disparities in obstructive sleep disordered breathing care. These groups are more likely to undergo polysomnography but less likely to have tonsillectomy without it.

Keywords:

ethnic and racial minorities healthcare disparities pediatrics polysomnography sleep‐disordered breathing tonsillectomy

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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

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Auricular Acupuncture as a Traditional Chinese Medicine Therapy for Chronic Obstructive Pulmonary Disease Combined with Sleep Disorders

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Published on: August 18, 2023

Area of Science:

Pediatric Otolaryngology
Health Services Research
Sleep Medicine

Background:

Obstructive sleep disordered breathing (OSDB) is a primary reason for pediatric tonsillectomy in the U.S.
Barriers to specialty care may lead to disparities in tonsillectomy rates.
Understanding these disparities is crucial for equitable healthcare access.

Purpose of the Study:

To examine how race, ethnicity, and urban/rural residence influence access to specialty care for children diagnosed with OSDB.
To identify potential disparities in diagnostic and surgical care pathways for pediatric OSDB.

Main Methods:

Retrospective observational cohort study.
Analysis of data from 304,415 children (ages 2-18) diagnosed with OSDB across 15 states (2017-2018).
Follow-up for 1 year to track receipt of polysomnography, otolaryngology visits, and tonsillectomy.

Main Results:

Care pathways varied significantly by race and ethnicity.
Black non-Hispanic and Hispanic children were more likely to undergo polysomnography (OR 1.06).
White non-Hispanic children were more likely to receive otolaryngology care/tonsillectomy without prior polysomnography.
Urban children were more likely to undergo polysomnography alone or before otolaryngology care (OR 1.06).

Conclusions:

Black non-Hispanic, Hispanic, and urban children experienced different care pathways for OSDB.
These groups were more likely to have polysomnography but less likely to have tonsillectomy without it.
Findings suggest potential unwarranted variations in diagnostic and surgical care based on race/ethnicity and location.