Parent and child-reported acceptability and preference of pediatric home sleep apnea testing versus In-lab polysomnography: a pilot study.

Objectives: In-lab polysomnography (PSG) remains the gold standard for the diagnosis of pediatric obstructive sleep apnea (OSA), but its limited availability has prompted the exploration of home sleep apnea testing (HSAT) with encephalogram (EEG) in children. While the feasibility and accuracy of HSAT have been studied previously in children, parent- and child-reported acceptability and preferences of HSAT compared with PSG are unknown. We aimed to evaluate factors influencing parent and child acceptability and preference of HSAT versus PSG. Methods: In this pilot study children aged 2-17.9 years completed PSG and comprehensive HSAT with EEG within one week of each other. Parents and older children completed questionnaires assessing feasibility, acceptability, sleep disturbances, and their preference of the two tests. A single structured phone interview with the parent was conducted one day after all study procedures, using ten open-ended questions. Results: Fifteen children participated and all completed testing. HSAT was reported to be feasible by 15 (100%) and doable by 14 (92.8%) parents. Seventy-nine percent of parents and 87.5% children liked the HSAT. HSAT was accepted by 79% of parents and 75% of the children. Overall, 60% of parents and 33% of children preferred HSAT over PSG. During HSAT, 64.3% of the parents needed to adjust sensors, mostly the nasal cannula (42.9%) and the pulse oximeter (66.7%). However, the majority did not find this bothersome. Conclusion: HSAT was feasible in children and preferred over PSG by parents but not children. During HSAT, children frequently had to have the sensors adjusted by parents. HSAT has the potential to be more widely acceptable if there is improvement to the stability of the nasal cannula and pulse oximeter.