P090 Acceptability, Feasibility and Accuracy of Home Sleep Studies in Children with Neuromuscular Disorders

INTRODUCTION & AIMS: Nocturnal hypoventilation may indicate declining pulmonary function in children with Neuromuscular Disorders (NMD). Hypoventilation is diagnosed with polysomnography (PSG), but there are significant barriers to the routine performance of PSG in this population. Home-based sleep studies (HSS) may reduce burden on patients and their families. We assessed the acceptability, feasibility and diagnostic accuracy of HSS for children with NMD. METHODS: 11 participants, aged 5-15, underwent PSG. A HSS was conducted within two weeks for comparison that included measurement of transcutaneous carbon dioxide. Hypoventilation was defined as pCO2 >50mmHg for >25% of total sleep time. Acceptability was assessed by a survey completed by the families. RESULTS: Preliminary analysis shows HSS feasibility of 91% (10/11). Of 10 technically acceptable HSS, there was a concordant diagnosis in 9 (90%). Exploratory analysis shows higher total sleep time (529 vs. 431 minutes, p<0.05), slow wave sleep (132 vs. 99 minutes, p<0.05) and REM sleep (115 vs. 83 minutes, p<0.05) during HSS. Correlation was excellent between the percentage of total sleep time with pCO2 >50mmHg (κ=0.94, p<0.05) for PSG and HSS. 93% of families preferred HSS to laboratory PSG. CONCLUSION: Preliminary analysis suggests home sleep studies that include transcutaneous carbon dioxide monitoring are feasible, acceptable and accurate when compared to PSG for diagnosing hypoventilation in children with NMD. These results imply that children may sleep better in the home environment. Further work is required to verify the diagnostic accuracy of home sleep studies in this group.