Non-Respiratory Indications for Polysomnography and Related Procedures in Children: An Evidence-Based Review

Abstract

These findings suggest that, in children with non-respiratory sleep disorders, polysomnography should be a part of a comprehensive sleep evaluation in selected circumstances to determine the nature of the events in more detail or when the suspicion of OSA is relatively high.

Evaluation and Treatment of Children and Adolescents With Excessive Daytime Sleepiness

“…45,46 Actigraphy is also used to confirm sufficient nighttime sleep before the PSG and MSLT (insufficient sleep can skew MSLT results). Overnight, in-laboratory PSG is particularly helpful for diagnosing OSA, periodic limb movement disorder, and narcolepsy in children and adults, 45,47 but it is not useful or indicated for evaluation of behavioral sleep disorders, including insomnia. 13 The MSLT assesses the propensity to fall asleep and is the standard test for quantifying EDS.…”

“…13 The MSLT assesses the propensity to fall asleep and is the standard test for quantifying EDS. 45,48 In addition to the presence of EDS, a mean sleep-onset latency ≤8 minutes and ≥2 sleep-onset rapid eye movement periods as assessed by the MSLT are diagnostic for narcolepsy. 49 However, the applicability of the MSLT for children is unclear, because normative values have not been established for children younger than 8 years, and mean values appear to vary across pediatric age categories.…”

“…49 However, the applicability of the MSLT for children is unclear, because normative values have not been established for children younger than 8 years, and mean values appear to vary across pediatric age categories. 45 The Maintenance of Wakefulness Test is a test of wakefulness used primarily to measure response to therapy for narcolepsy and hypersomnia (ie, effects on EDS), and it may also help judge the risk of vehicle crashes or other injury in patients with EDS. 2,48…”

Value of combined video EEG and polysomnography in clinical management of children with epilepsy and daytime or nocturnal spells

“…Moreover, sleep disorders are common in children with epilepsy. Sleep evaluation may require a polysomnography [10,11]. Additionally, children with epilepsy may require prolonged video EEG during the course of their disease to confirm diagnosis, evaluate additional events/spells, quantify seizure frequency, evaluate the drug response, and assess the readiness for medication wean [12,13].…”

Pediatric sleep studies

“…[10]. Kotagal et al[11] published an accompanying evidence-based review for the nonrespiratory indications for PSG. It consists of five nap opportunities and is the primary test to evaluate narcolepsy.…”