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Abstract Introduction Sleep disordered breathing (SDB) refers to abnormalities in ventilation and oxygenation that occur during sleep. Common etiologies of SDB include obesity, craniofacial abnormalities, neuromuscular disorders, and adenotonsillar hypertrophy. The gold standard for diagnosis of SDB is polysomnography (PSG) which evaluates for obstructive sleep apnea, central apnea, persistent desaturations, nocturnal hypoxia, or to determine readiness for decannulation from tracheostomy, and can be performed in either the outpatient or inpatient setting. The primary objective of this study is to determine any temporal changes in patient demographics, PSG parameters, and prevalence of airway comorbidities among pediatric patients receiving at least one inpatient PSG during the COVID19 pandemic, from 2019 through 2022. Methods Retrospective analysis of medical records from 422 pediatric patients admitted to Children’s Hospital in Dallas from 2019 through 2022 who received at least one PSG was conducted. Parameters from PSG were recorded and analyzed. Values and demographics from each year were compared against each other and analyzed. Results A total of 422 children had 467 PSGs from 2019 through 2022. Demographically, there was no difference in age, gender, height, weight, race, ethnicity, language spoken at home, or primary insurance over these years. In terms of PSG parameters, there was a significant difference in AHI between 2019 12.83(95%CI 9.33-16.32) and 2022 19.04(95%CI 12.39-25.69, p 0.05) as well as percentage of total sleep time spent hypercapnic between 2020 9.78%(95%CI 5.09-14.48%) and 2022 4.90%(95%CI 1.55-8.24%, p 0.01). There was no difference among prevalence of airway comorbidities. There was also a significant difference in hospital stay between children hospitalized in 2019 15.29(95%CI 12.06-18.52 days) compared to 2020 25.98(95%CI 18.10-33.85 days, p 0.05), 2021 29.74(95%CI 19.00-40.48 days, p 0.05), and 2022 31.24(95%CI 24.04-38.44 days, p 0.001). Conclusion Hospitalized pediatric patients in 2019 prior to the onset of COVID19 pandemic had shorter hospital stays compared to 2020, 2021, and 2022. The longer length of hospital stay observed in 2020-2022 likely reflected initiatives to limit inpatient PSGs in favor of performing them in the outpatient setting. Further research comparing the specific management by PSG metrics would provide insight on changes in treatments for SDB throughout the COVID19 pandemic. Support (if any)
Williams et al. (2024) studied this question.