0527 Reasons for Early Polysomnography Termination in Pediatric Patients with Sleep-Disordered Breathing

Abstract

Abstract Introduction Many children with possible obstructive sleep apnea remain unidentified due to low referral rate. Out of the patients who successfully get referred, scheduled, and show up to their polysomnography (PSG), a proportion fail to complete the study. Our focus is to explore what factors can lead to early PSG termination in hopes of proactively identifying the at-risk groups and implementing strategies in the future to help bridge the gap between scheduled and completed studies. Methods The sleep lab at the Pediatric Sleep Center at UT Southwestern Medical Center includes 20 pediatric beds across two sites, with >4000 pediatric sleep studies run per year. We retrospectively reviewed all studies from January 1, 2017 through December 31, 2019 that were terminated before study completion. We investigated reasons for early termination in each case and gathered patient characteristics such as age, gender, presence of neurocognitive impairment, payor status to identify predictors of unsuccessful studies. We also looked at variability in time of year and testing sites in early study termination. Results From the data review of 138 patients, we identified the 3 main reasons for termination to be intolerance to equipment (n=65), acute illness (n=45), or refusal by parent (n=28). There was a greater proportion of patients who terminated due to illness, relative to the other two reasons, in the winter (p = 0.01 refusal by parent; p = 0.02 intolerance to equipment) and a lesser percentage in the summer (p = 0.003 refusal by parent; p < 0.001 intolerance to equipment). There was a greater proportion of subjects who were neurocognitively impaired that terminated due to intolerance to equipment relative to those that terminated due to illness (p = 0.002). Conclusion In our retrospective analysis of the three main reasons for early PSG termination, we did not notice any difference between location sites, age groups, or payor status. In the future, efforts to prevent underutilization of the lab should focus on illness screening especially in the summer and winter as well as development of tools to assess tolerance especially in the neurologically impaired. Support (If Any)