REVIEW: NON-RESPIRATORY INDICATIONS FOR PSG IN CHILDREN
Non-Respiratory Indications for Polysomnography and Related Procedures in Children: An Evidence-Based Review
Suresh Kotagal, MD1; Cynthia D. Nichols, PhD2; Madeleine M. Grigg-Damberger, MD3; Carole L. Marcus, MBBCh4; Manisha B. Witmans, MD5; Valerie G. Kirk, MD6; Lynn A. D'Andrea, MD7; Timothy F. Hoban, MD8
1Mayo Clinic, Rochester, MN; 2Munson Medical Center, Traverse City, MI; 3University of New Mexico School of Medicine, Albuquerque, NM; 4University of Pennsylvania, Philadelphia, PA; 5Stollery Children's Hospital and University of Alberta, Edmonton, AB; 6Alberta Children's Hospital and University of Calgary, Calgary, AB; 7Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI; 8University of Michigan, Ann Arbor, MI
This evidence-based review provides a systematic and comprehensive review of the literature regarding the utility of polysomnography for the evaluation of non-respiratory sleep disorders in children including hypersomnias, parasomnias, sleep-related movement disorders, and sleep in other special populations.
A task force of pediatric sleep medicine experts performed a systematic review of the literature regarding the use of polysomnography for non-respiratory sleep disorders in children. They identified and graded 76 papers as evidence.
The main results include (1) polysomnography combined with the multiple sleep latency test is useful for evaluating disorders of excessive somnolence to objectively quantify sleepiness. The results have to be interpreted with consideration of the pubertal stage and regularity of the sleep patterns of the child; (2) polysomnography is indicated in children with parasomnias or sleep related movement disorders who have a high likelihood of having obstructive sleep apnea (OSA); (3) polysomnography is not routinely indicated in children with enuresis unless there is a high likelihood of OSA; (4) polysomnography can be helpful in evaluating children with restless legs syndrome (RLS) and when periodic limb movement disorder (PLMD) is suspected.
These findings suggest that, in children with non-respiratory sleep disorders, polysomnography should be a part of a comprehensive sleep evaluation in selected circumstances to determine the nature of the events in more detail or when the suspicion of OSA is relatively high.
Kotagal S; Nichols CD; Grigg-Damberger MM; Marcus CL; Witmans MB; Kirk VG; D'Andrea LA; Hoban TF. Non-respiratory indications for polysomnography and related procedures in children: an evidence-based review. SLEEP 2012;35(11):1451-1466.