Sleep studies frequently lead to changes in respiratory support in children

Abstract

International guidelines recommend that children who are managed at home with mechanical respiratory support (RS) should have sleep studies performed every 6-12 months. This recommendation is based on expert opinion, with little evidence to support it. No studies have been undertaken to examine the utility of sleep studies in children on RS. A retrospective review of sleep studies performed over a 12-month period was undertaken at a New Zealand paediatric sleep medicine referral centre, to determine changes made to RS following sleep studies. Sixty-one sleep studies were performed for assessment of RS in 45 children (27 boys; median age 8.3 years; range 0.4-18.6 years). Twenty-nine (64%) children were on continuous positive airway pressure, 14 (31%) on bi-level non-invasive ventilation, and two (4%) on tracheostomy ventilation. A change was made to RS settings after 66% of studies. No clinical parameters predicted which children would require a change in settings. Although sleep studies are expensive and time-consuming, follow-up studies of children on RS provide important information for optimising management into the long term.