Tolerance of polysomnography in children with neurodevelopmental disorders compared to neurotypical peers.

STUDY OBJECTIVES: Diagnostic polysomnography (PSG) is the gold standard test to evaluate sleep-disordered breathing (SDB) in children. Little is known about how children with neurodevelopmental disorders (NDD) tolerate electrodes and sensors in PSG compared to neurotypical children.

METHODS: In this retrospective cohort study of children >12 months of age who underwent diagnostic PSG at our center from 01/01/2021-30/06/2021, we used sleep technician and physician reports to determine how PSG was tolerated in children with NDD compared to neurotypical children. Sub-analyses included tolerance of individual electrodes and sensors, and sub-groups of NDD (e.g. Trisomy 21).

RESULTS: 132 children with a NDD and 139 neurotypical children underwent diagnostic PSG. The median age of all children was 8 years, 39% were female, and 50% had a sleep disorder identified on PSG, with no significant differences between NDD and neurotypical groups. The most-poorly tolerated sensors for all children were the nasal prongs (poorly tolerated in 30% of all children), followed by thermistor (14%) and electroencephalography (EEG) electrodes (6%). Children with NDD were >3 times more likely (Odds Ratio 3.1, 95% confidence interval 1.8-5.3) to experience problems tolerating any study leads than neurotypical children. Subgroup analysis revealed children with Trisomy 21 had the greatest difficulty tolerating PSG set-up and leads.

CONCLUSIONS: This retrospective study demonstrates that children with neurodevelopmental disorders are less likely to tolerate PSG monitoring than neurotypical children and highlights the need to develop alternative measures for evaluation of sleep disorders in this population.