Comparing home polysomnography with transcutaneous CO 2 monitoring to laboratory polysomnography in children with neuromuscular disorders.

Autor: Withers A; Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, Western Australia, Australia.; The Kids Research Institute Australia, Perth, Western Australia, Australia.; Curtin University, Perth, Western Australia, Australia., Pettigrew G; The Kids Research Institute Australia, Perth, Western Australia, Australia., Filmer K; Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, Western Australia, Australia., Lam J; The Kids Research Institute Australia, Perth, Western Australia, Australia., Downs J; The Kids Research Institute Australia, Perth, Western Australia, Australia.; Curtin University, Perth, Western Australia, Australia., Wilson A; Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, Western Australia, Australia.; The Kids Research Institute Australia, Perth, Western Australia, Australia.; Curtin University, Perth, Western Australia, Australia.
Jazyk: angličtina
Zdroj: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2024 Dec 12. Date of Electronic Publication: 2024 Dec 12.
DOI: 10.5664/jcsm.11490
Abstrakt: Study Objectives: Clinical utility of home polysomnography in children with neuromuscular disorders is limited by lack of evidence that sleep-disordered breathing can be reliably identified and inability to diagnose hypoventilation as carbon dioxide is not measured.
Methods: This study aimed to determine feasibility, accuracy and parent satisfaction for home polysomnography performed with a Type 2 portable monitoring device and a transcutaneous CO 2 monitor. Results of laboratory and home polysomnography were compared with Mann-Whitney U tests and random intercept regression models.
Results: Nineteen paired polysomnograms were performed for participants with various neuromuscular disorders at a median age of nine years. Feasibility was 68%, defined as adequate data recorded from the portable monitoring device and transcutaneous CO 2 monitor. Adequate transcutaneous CO 2 data was recorded in 89% of home studies. Significant differences were higher total sleep time, less awake time and less N1 sleep during home polysomnography. Home polysomnography had sensitivity of 50% for diagnosis of hypoventilation and 78% for obstructive sleep apnea. Home polysomnography under-estimated severity of obstructive sleep apnea in three cases. Parent satisfaction for home polysomnography was high.
Conclusions: This is the first study to measure transcutaneous CO 2 during home polysomnography in children with neuromuscular disorders. Results suggest better sleep quality at home during testing. Current sensitivity of home polysomnography for the diagnosis of sleep-disordered breathing is too low for clinical use, however, the feasibility of transcutaneous CO 2 measurement in the home and high satisfaction justifies further research to improve accuracy of home polysomnography in this population.
(© 2024 American Academy of Sleep Medicine.)
Databáze: MEDLINE
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