Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
Comparing home polysomnography with transcutaneous CO2 monitoring to laboratory polysomnography in children with neuromuscular disorders.
СтатьяСравнительное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Withers Adelaide, Pettigrew Grace, Filmer Kirrily, Lam Jenny, Downs Jenny, Wilson Andrew
Аннотация
STUDY OBJECTIVES: Clinical utility of home polysomnography in children with neuromuscular disorders is limited by lack of evidence that sleep-disordered breathing can be reliably identified and inability to diagnose hypoventilation because carbon dioxide is not measured.
METHODS: This study aimed to determine the feasibility, accuracy, and parent satisfaction for home polysomnography performed with a type 2 portable monitoring device and a transcutaneous CO2 monitor. Results of laboratory and home polysomnography were compared with Mann-Whitney U tests and random intercept regression models.
RESULTS: Nineteen paired polysomnograms were performed for participants with various neuromuscular disorders at a median age of 9 years. Feasibility, defined as adequate data recorded from the portable monitoring device and transcutaneous CO2 monitor, was 68%. Adequate transcutaneous CO2 data were recorded in 89% of home studies. Significant differences were higher total sleep time, less awake time, and less N1 sleep during home polysomnography. Home polysomnography had a sensitivity of 50% for diagnosis of hypoventilation and 78% for obstructive sleep apnea. Home polysomnography underestimated severity of obstructive sleep apnea in 3 cases. Parent satisfaction for home polysomnography was high.
CONCLUSIONS: This is the first study to measure transcutaneous CO2 during type 2 home polysomnography in children with neuromuscular disorders. Results suggest better sleep quality at home during testing. Current sensitivity of home polysomnography for the diagnosis of sleep-disordered breathing is too low for clinical use; however, the feasibility of transcutaneous CO2 measurement in the home and high satisfaction justify further research to improve accuracy of home polysomnography in this population.
CITATION: Withers A, Pettigrew G, Filmer K, Lam J, Downs J, Wilson A. Comparing home polysomnography with transcutaneous CO2 monitoring to laboratory polysomnography in children with neuromuscular disorders. J Clin Sleep Med. 2025;21(4):639-648.
METHODS: This study aimed to determine the feasibility, accuracy, and parent satisfaction for home polysomnography performed with a type 2 portable monitoring device and a transcutaneous CO2 monitor. Results of laboratory and home polysomnography were compared with Mann-Whitney U tests and random intercept regression models.
RESULTS: Nineteen paired polysomnograms were performed for participants with various neuromuscular disorders at a median age of 9 years. Feasibility, defined as adequate data recorded from the portable monitoring device and transcutaneous CO2 monitor, was 68%. Adequate transcutaneous CO2 data were recorded in 89% of home studies. Significant differences were higher total sleep time, less awake time, and less N1 sleep during home polysomnography. Home polysomnography had a sensitivity of 50% for diagnosis of hypoventilation and 78% for obstructive sleep apnea. Home polysomnography underestimated severity of obstructive sleep apnea in 3 cases. Parent satisfaction for home polysomnography was high.
CONCLUSIONS: This is the first study to measure transcutaneous CO2 during type 2 home polysomnography in children with neuromuscular disorders. Results suggest better sleep quality at home during testing. Current sensitivity of home polysomnography for the diagnosis of sleep-disordered breathing is too low for clinical use; however, the feasibility of transcutaneous CO2 measurement in the home and high satisfaction justify further research to improve accuracy of home polysomnography in this population.
CITATION: Withers A, Pettigrew G, Filmer K, Lam J, Downs J, Wilson A. Comparing home polysomnography with transcutaneous CO2 monitoring to laboratory polysomnography in children with neuromuscular disorders. J Clin Sleep Med. 2025;21(4):639-648.