ArticleSleep & breathing = Schlaf & Atmung2026
Night-to-night variability in respiratory outcomes from home sleep testing in children with suspected sleep-disordered breathing: a retrospective analysis using real-world data.
Article in Sleep & breathing = Schlaf & Atmung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
purposePediatric obstructive sleep-disordered breathing (SDB) is frequently diagnosed using single-night home sleep apnea testing (HSAT). However, concerns persist regarding diagnostic accuracy due to night-to-night variability and the first-night effect, defined as systematic differences between the first and subsequent nights. Previous research on pediatric polysomnography has yielded conflicting findings regarding these phenomena. This study assesses the presence of a first-night effect and quantifies night-to-night variability in respiratory parameters among children undergoing HSAT.
methodsThis retrospective study analyzed respiratory polygraphy data collected over two consecutive nights from a real-world, unselected population of children with suspected SDB. The primary outcome was the difference in apnea-hypopnea index (AHI) between the first and second nights, commonly referred to as the first-night effect. Secondary outcomes included differences in other respiratory parameters and between-night accuracy in diagnosing obstructive sleep apnea (OSA).
resultsForty-eight children (median age: 6.7 years, 75% male) were included in the analysis. No systematic differences were detected between the first and second nights in AHI or other respiratory parameters, suggesting an absence of the first-night effect. Nevertheless, for some participants, measurements varied widely between nights. This resulted in 29% of children changing the diagnostic category of OSA between nights.
conclusionPediatric HSAT in this real-world population with mostly mild SDB symptoms demonstrates no significant first-night effect; however, moderate night-to-night variability exists in some children. Clinicians must consider this variability when interpreting HSAT results in cases where clinical presentation and single-night HSAT outcomes conflict; a multi-night assessment may be warranted to improve diagnostic accuracy.
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