Abstract Rationale While in-laboratory polysomnography (PSG) remains the gold standard for diagnosing obstructive sleep apnea (OSA), recent studies have validated home sleep apnea testing (HSAT) as an alternative. However, these studies are limited to the adult population, leaving the pediatric population largely unexplored. HSAT offers several advantages over PSG including patient convenience, faster results, and cost effectiveness. Our study aims to explore the efficacy of HSAT in diagnosing pediatric OSA. Methods We retrospectively evaluated HSAT using a type 3 portable monitor (Nox-T3, Nox Medical, Reykjavik, Iceland) performed with pediatric patients aged 2-19 years old (N = 102) at the Orlando Health Pediatric Pulmonology and Sleep Medicine Clinic. Patients with suspected OSA identified by pre-HSAT clinic visit were included in the study. Exclusion criteria included total sleep time 6 hours and medical complexity (e.g., complex pulmonary comorbidities), for which in-lab PSG was deemed more appropriate. HSAT data for 97 patients were analyzed. Results The mean total recording time was 9.3 hours with a mean total sleep time of 8.4 hours. Sleep efficiency was high, with an average of 91.2%. HSAT was positive (portable apnea-hypopnea index pAHI = 1.0) in 43% of patients. Mean AHI was 13.4 events/hour in positive studies and 0.3 events/hour in negative studies. Tonsillar hypertrophy (grade 3+ or 4+) on pre-HSAT clinic examination was highly predictive of a positive HSAT (86% positive predictive value). The testing modality was well-tolerated across the age range. Valid studies were collected in patients with comorbidities including autism spectrum disorder, Williams syndrome, craniofacial syndromes, and Trisomy 21. Discussion HSAT is an effective tool for diagnosing OSA in the pediatric population. Older children ( =8 years) yield the most reliable results due to increased compliance with the home sleep test apparatus. Notably, children who are difficult to test in the laboratory (due to congenital syndromes, developmental delay, or neuromuscular weakness) may particularly benefit from HSAT. Our center has received positive feedback about home testing from parents of children with developmental delays and autism spectrum disorders. In addition, HSAT enables sleep centers to evaluate more children while significantly reducing healthcare costs. This abstract is funded by: None
Rio et al. (Fri,) studied this question.