Home cardiorespiratory sleep studies in children and young people: experience of a UK Regional Service

ABSTRACT

Background: Cardiorespiratory sleep studies (CRSS) consisting of effort, flow, oxygen saturation, ECG traces and video is traditionally undertaken in hospital with an attendant physiologist. Over the last 10 years our service has increasingly undertaken such studies in the child or young person's (CYP) home. This is now our default means of undertaking such studies. Objective(s) To determine the technical adequacy and clinical utility of home cardiorespiratory sleep studies in our patient group. Method(s) Retrospective data service evaluation. Patient demographics, underlying diagnosis and clinical question were recorded for those for whom home video CRPSG was attempted between July 2020-August 2021. The adequacy of each study component was scored (1=inadequate;2=variable;3=excellent) using the narrative in the study report. A total adequacy score (TAS) was calculated for each study. Result(s) 50 studies were identified (mean age of CYP was 5.5 years (IQR=8.5)). A clinical conclusion was possible for 96% of studies. 36% of studies were positive for a breathing disorder. Electrocardiography had the highest percentage (85.7%) of 'excellent' scores. Nasal thermistor had the highest percentage (32.7%) of 'inadequate' scores. Age of CYP and adequacy scores were not related. There was no association between underlying diagnosis and clinical utility/adequacy of study. Conclusion(s) For a service without access to in-hospital attended studies, we can achieve a high rate of technical adequacy and clinical utility for home CRSS irrespective of age and underlying diagnosis for CYP. We have been able to continue our service despite the COVID pandemic.