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Study Objectives: <p>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.</p> Methods: <p>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 CO<sub>2</sub> monitor. Results of laboratory and home polysomnography were compared with Mann–Whitney U tests and random intercept regression models.</p> Results: <p>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 CO<sub>2</sub> monitor, was 68%. Adequate transcutaneous CO<sub>2</sub> 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.</p> Conclusions: <p>This is the first study to measure transcutaneous CO<sub>2</sub> 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 CO<sub>2</sub> measurement in the home and high satisfaction justify further research to improve accuracy of home polysomnography in this population.</p> Citation: <p>Withers A, Pettigrew G, Filmer K, Lam J, Downs J, Wilson A. Comparing home polysomnography with transcutaneous CO<sub>2</sub> monitoring to laboratory polysomnography in children with neuromuscular disorders. <i>J Clin Sleep Med.</i> 2025;21(4):639–648.</p>

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Comparing home polysomnography with transcutaneous CO2 monitoring to laboratory polysomnography in children with neuromuscular disorders

  • 期刊论文

  • 发表日期：

    2025年4月1日

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  • Adelaide Withers,
  • Grace Pettigrew,
  • Kirrily Filmer,
  • Jenny Lam,
  • Jenny Downs,
  • Andrew Wilson

摘要

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.