Abstract
Abstract Introduction The gold standard for diagnosis of paediatric obstructive sleep apnoea (OSA) is attended in-laboratory level 1 polysomnography (PSG). In our service, we select some children for unattended home level 2 PSG (HPSG) with telehealth support. We audited our HPSG service from 2013 to 2020. Methods We retrospectively audited level 2 home PSG reports in children aged 5–18 years referred for suspected OSA between 2013 and 2020. Tests were performed with the Compumedics Somte PSG acquisition device. The primary outcome was % of studies achieving a technically adequate diagnosis. Secondary outcomes included sleep duration, sleep efficiency and parental acceptance by non-validated service-specific questionnaire. Data was analysed using descriptive & inferential statistics. χ² tests were used for categorical variables. Results There were 235 (140 male, 59.6%) patients studied between 2013 and 2020 (7 years). The mean age was 10.8 (SD 3.6) years. 69 patients (29.4%) had co-morbidities. Repeat studies were indicated in 10.2% (24/235) due to technical failure. There was no significant difference between failed studies set up by HITH nurses compared with Sleep scientists (p=0.1). A technically acceptable diagnosis was made in 87% (205/235) patients, with no reason for under-estimation in 74.9%, and potential under-estimation in 17.9%. No diagnosis was achieved in 7.2%. 6 hrs or more sleep was obtained in 83%. Parental questionnaires revealed 89% perceived high-level care, 91% perceived increased convenience and 76% good/excellent telehealth support. Discussion Telehealth-supported paediatric HPSG achieves a technically adequate diagnosis in 87%, with 83% achieving ≥6 hrs sleep duration, and excellent family acceptability.
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