Reasons and predictors for early termination of pediatric polysomnography: one children's hospital's experience

STUDY OBJECTIVES

We sought to identify reasons for early polysomnography termination in pediatric patients.

METHODS

We retrospectively reviewed all studies conducted at the Pediatric Sleep Center at UT Southwestern Medical Center from January 1, 2017, through December 31, 2019, that were terminated before study completion. We investigated reasons for early termination and gathered characteristics such as age, sex, presence of neurocognitive impairment, payor status, seasonal variability, and testing site location.

RESULTS

There were 137 patients who terminated their studies before completion, comprising 1.05% of all patients who arrived for their scheduled polysomnographies during that time frame. The 3 main categories of reasons were equipment intolerance (47%), acute illness (33%), and parental refusal (20%). Parental refusal reasons included the patient's becoming combative, a lack of specialized equipment, patient's inability to fall asleep, forgetting the patient's nighttime medications, and the parent's inability to stay the night. Males represented a greater proportion of those who terminated due to intolerance of equipment (75%). Patients who terminated early due to equipment intolerance consisted of more neurologically impaired patients compared with those who terminated due to acute illness (56% vs 24%). Termination due to acute illness occurred more during the wintertime (44%) than in the summer (7%). In those who terminated due to parental refusal, there was a greater proportion of children under 6 years of age (75%).

CONCLUSIONS

Determining factors that are associated with early polysomnography termination is an important step to help identify at-risk groups and implement strategies to improve study completion.

CITATION

Luong S, Culp M, McCreary M, Wani A, Caraballo M. Reasons and predictors for early termination of pediatric polysomnography: one children's hospital's experience. J Clin Sleep Med. 2023;19(10):1711-1716.

Sleep and Covid-19

Background

COVID-19 pandemic has affected the world globally causing widespread repercussions on individuals' physical, mental and emotional well-being. In such times, sleep is likely to be affected.

Objective

The aim of this study was to present the available literature on sleep and also the foresight as to the future national strategy to mitigate the effects of this pandemic.

Materials and Methods

An extensive literature search on PubMed, Google Scholar, Epistemonikos database (https://www.epistemonikos.org), PsycINFO for available literature on the prevalence of sleep problem on COVID-19 was done. Cross-citation search was also conducted to increase relevance of the review. The key words used were- (((((((((((insomnia)) OR (sleep)) OR (sleepiness)) OR ("sleep quality")) OR (OSA)) OR ("obstructive sleep apnoea")) OR ("obstructive sleep apnea")) OR (("sleep problem")) AND "covid-19" OR covid19* OR "COVID-19" OR "2019-nCoV" OR cv19* OR "cv-19" OR "cv 19" OR "n-cov" OR ncov* OR "sars-cov-2" OR "sars-cov2" OR "2019-ncov" OR "SARS-Coronavirus-2" OR "SARS-Coronavirus2" OR (wuhan* AND (virus OR viruses OR viral)) OR (covid* AND (virus OR viruses OR viral)) OR "covid-19-related" OR "SARS-CoV-2-related" OR "SARS-CoV2-related" OR "2019-nCoV-related" OR "cv-19-related" OR "n-cov-related"). Inclusion criteria consisted of articles in English, published from Jan 2020 till 19 Apr 2020. Two reviewers independently screened each research study for inclusion and eligibility.

Results and Conclusion

Sleep is affected during COVID-19 pandemic in patients, their families, health-care workers and their families, population in isolation, and quarantine and as such in public. Limited literature exists with subjective data and no objective criteria were found to study sleep in COVID-19 pandemic. OSA was found to be a frequent baseline characteristic of COVID-19 patients. A need to follow guidelines is of paramount importance and strategies to better sleep in the population needs to be addressed.