0756 Use of Split-Night Polysomnography in Children with Sleep Disordered Breathing

• Published in: Sleep (New York, N.Y.) Vol. 41; no. suppl_1; p. A281
• Main Authors: Gerdung, C A, Castro Codesal, M L, Nettle-Aguirre, A, Kam, K, Hanly, P J, Maclean, J E, Bendiak, G N
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 27.04.2018
• Subjects: Efficiency; Pediatrics; Sleep
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsy061.755

Abstract Introduction Split Night Polysomnography (snPSG) is used in adults to combine diagnostic and therapeutic assessments into a single night study. There is a paucity of data in the pediatric population, and routine use of snPSG is not well established. Despite a lack of published literature, it is believed that snPSG may be unsuccessful due to intolerance of positive airway pressure (PAP) initiation without acclimatization. We describe a large cohort of children with sleep disordered breathing (SDB) who underwent snPSG. We hypothesize that snPSG will not affect sleep latency or efficiency. Methods Data was obtained from a larger database collecting retrospective data on children 0–17 years of age who received PAP in a home-based setting for at least 3 months in the province of Alberta. Children started on PAP during snPSG between May 2010 and December 2014 were identified. Demographics and snPSG data were analyzed. Data presented as median (first quartile, third quartile). Results PAP was first started during snPSG in 180 patients. Patient age was 7.2 years (1.6, 13.0), and 70% were male. During the diagnostic portion, sleep latency was 10.5min (3.5, 20.7) with a total sleep time (TST) of 210.0min (151, 280.6). Sleep efficiency was 85.1% (77.1, 91.9). AHI was 16.8 (8.3, 43.9). Mean end-tidal CO2 (ETCO2) was 44.9mmHg (41.9, 47.7) and mean transcutaneous CO2 (TCCO2) was 44.8mmHg (41.7, 47.5). Fourty-nine patients had ETCO2 or TCCO2 above 50mmHg for greater than 25% of TST. After initiating PAP during snPSG, sleep latency was 5.5min (0.9, 17.3) with a TST of 203.0min (128.7, 265.3). Sleep efficiency was 84.7% (74.7%, 92.1%). AHI was 5.5 (2.0, 12.0). Mean TCCO2 was 42.6mmHg (38.9, 46.9). Twenty-one patients had TCCO2 above 50mmHg for greater than 25% of TST. Conclusion Sleep latency and sleep efficiency were preserved between diagnostic and titration portions of snPSGs. snSPG may be a viable option for pediatric patients, and should be explored further. Given the limited access to PSG in Canada, snPSG may provide a viable route to reduce numbers of PSGs required for diagnosis and treatment. Support (If Any) None.