Performing polysomnography in pre-school aged children: challenging parts of the procedure and risk factors for lead intolerance

Pediatric sleep apnea begins in toddlerhood when sleep is vital for neurocognitive development and rapid somatic growth. As polysomnography (PSG) can be challenging in this age group, this study described the first PSG for children aged 2 to 6 years old in regards to completion and risk-factors for intolerance.

Single center chart review in a pediatric-only hospital-based sleep center.

Of the 342 children age 2 to 6 years old, 99.5% completed the study and 56% cooperated with the full hook-up; the nasal monitors were the least tolerated. Children who did not achieve a full hook-up slept 0.7 h fewer (p = 0.04), woke up more often (p = 0.015), and took 15 min longer to fall asleep (p = 0.012). Younger age and having autism were independent risk factors for poor tolerance.

The majority of pre-schoolers tolerated their first PSG. Interventional trials to increase PSG success in this population should prepare those under 3-years-old and with sensory processing issues to cooperate with nasal monitors.