Cardiorespiratory sleep studies at home: experience in research and clinical cohorts

Abstract

ObjectiveTo evaluate the success rates of home cardiorespiratory polygraphy in children under investigation for sleep-disordered breathing and parent perspectives on equipment use at home.DesignProspective observational study.SettingSheffield, Evelina London and Southampton Children’s Hospitals.PatientsData are reported for 194 research participants with Down syndrome, aged 0.5–5.9 years across the three centres and 61 clinical patients aged 0.4–19.5 years from one centre, all of whom had home cardiorespiratory polygraphy including respiratory movements, nasal pressure flow, pulse oximetry, body position and motion.Main outcome measuresPercentage of home cardiorespiratory studies successfully acquiring ≥4 hours of artefact-free data at the first attempt. Parental report of ease of use of equipment and preparedness to repeat home diagnostics in the future.Results143/194 (74%; 95% CI 67% to 79%) of research participants and 50/61 (82%; 95% CI 71% to 90%) of clinical patients had successful home cardiorespiratory polygraphy at the first attempt. Some children required multiple attempts to achieve a successful study. Overall, this equated to 1.3 studies per research participant and 1.2 studies per clinical child. The median artefact-free sleep time for successful research studies was 515 min (range 261–673) and for clinical studies 442 min (range 291–583). 84% of research and 87% of clinical parents expressed willingness to repeat home cardiorespiratory polygraphy in the future. 67% of research parents found the equipment ‘easy or okay’ to use, while 64% of clinical parents reported it as ‘easy’ or ‘very easy’.ConclusionsHome cardiorespiratory polygraphy offers an acceptable approach to the assessment of sleep-disordered breathing in children.

Psychometric Properties and Predictive Value of a Screening Questionnaire for Obstructive Sleep Apnea in Young Children With Down Syndrome

“…OSA was assessed using the SOMNOtouch device (SOMNOmedics, Germany) comprising chest and abdominal respiratory inductance plethysmography (RIP) bands, internal pulse oximetry, nasal pressure flow with snore sensor, body position sensor, and actigraphy. We have previously reported our positive experience of domiciliary studies in this population (34). A sleep log recorded sleep onset, night waking's, and morning wake up times.…”

“…36.16 (SD 20.6) (range 6-71)34.87 (SD 20.3) (range: 6-71) 38.68 (SD 21.1) (range 6-71) 0.659 BM1 > 95 th centile [restricted to those aged ≥ 2Further clarification of educational level: 1. GCSE at level C: has passed examinations conducted at the age of 16 years, 2.…”

Sleep laboratories reopening and COVID-19: a European perspective

“…require surveillance for SDB, even in the absence of symptoms. Kingshott et al have recently shown a more encouraging outcome to cardiopulmonary polygraphy studies being performed at home in children, with 82% of clinical studies being successful at first attempt and parents confirming ease of use [ 25 ].…”

Follow-Up and Monitoring of Children Needing Long Term Home Ventilation

“…PSG may also be valuable as it also allows recording of the mask pressure in order to monitor the delivered pressure, but also detects leaks and patient-ventilator synchrony (3), as well as identifying and characterizing residual respiratory events (26,27). Whether P(S)G should be done only during inhospital overnight or also at home (23) is not clear, because of the lack of studies reporting the use and feasibility of P(S)G at home in children receiving noninvasive respiratory support (28,29).…”