Feasibility and clinical utility of daytime polysomnography performed in NICU to diagnose sleep disordered breathing in infants.

IF 2.3 4区 医学 Q2 PEDIATRICS
Dimple Goel, Andrew Wilson, Anne O'Donnell, Chloe Lappin, Rhiannon Plavsic, Tracey Verstandig, Shripada Rao, Max K Bulsara, Kellie Francis, Catherine Dunstan, Gareth Baynam, Karen Waters
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Abstract

Objective: To assess the feasibility and clinical utility of daytime polysomnography (PSG) in infants <3 months of age.

Methods: A prospective observational study of a convenience cohort analysing PSGs that were conducted for clinical purposes in infants less <3 months of age, between 1 May 2021 and 31 May 2024. A comparison was made between results for daytime PSG in the neonatal intensive care unit (NICU) and overnight PSG in the sleep laboratory. The type of PSG performed (daytime vs overnight) was based on the workflow of the sleep laboratory. Primary outcomes were successfully completed PSGs (feasibility) and per cent sleep efficiency (clinical utility). Secondary outcomes compared other sleep parameters between groups. Patient and public feedback directly informed the development of the research question and outcome measures.

Results: Of 60 PSGs, 28 were daytime and 32 were overnight. Daytime studies had a younger age (median 18 vs 55 days, p<0.001) and shorter median recording time (8.2 vs 10.4 hours, p<0.001). All daytime PSGs were successful, indicating feasibility. After adjusting for age at PSG and total recording time, per cent sleep efficiency was equivalent in the two groups (95% CI -12.4 to 5.7; p 0.456), indicating their clinical utility. For secondary outcomes, daytime PSGs had a higher % rapid eye movement (REM) sleep by 9.9% points (95% CI 1.1 to 18.8; p 0.028) compared with overnight PSG. Parameters that were not different included: frequency of spontaneous arousals, REM latency, sleep latency, Apnoea-Hypopnoea Index and Obstructive Apnoea-Hypopnoea Index. A decline in requests for overnight PSGs and a corresponding increase in daytime PSGs over the course of the study were observed.

Conclusion: Daytime PSGs performed in NICU were feasible and provided clinically useful results in infants <3 months of age. Availability of daytime PSGs performed at the infant's bedside expands resource capacity and has the potential for cost savings.

Abstract Image

Abstract Image

新生儿重症监护病房日间多导睡眠图诊断婴儿睡眠呼吸障碍的可行性及临床应用。
目的:评估日间多导睡眠图(PSG)在婴儿中的可行性和临床应用方法:一项前瞻性观察性研究,对用于临床目的的婴幼儿多导睡眠图进行了便捷队列分析。结果:60例多导睡眠图中,28例为日间多导睡眠图,32例为夜间多导睡眠图。日间研究的年龄更小(中位年龄为18天和55天)。结论:日间在新生儿重症监护病房进行psg是可行的,并为婴儿提供了临床有用的结果
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来源期刊
BMJ Paediatrics Open
BMJ Paediatrics Open Medicine-Pediatrics, Perinatology and Child Health
CiteScore
4.10
自引率
3.80%
发文量
124
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