O014 Tolerance of polysomnography in children with neurodisability versus neurotypical peers

BACKGROUND: Diagnostic polysomnography (PSG) is the gold standard test to evaluate children for sleep-disordered breathing (SDB). Little is known about how well children with neurodisability tolerate the components of PSG compared to neurotypical children. METHODS: We conducted a retrospective cohort study of children >12 months old who underwent diagnostic PSG at our centre from 01/01/2021-30/06/2021, examining how PSG-related monitoring leads were tolerated, based primarily on sleep technician and physician reports. Data extracted included reports of how children tolerated PSG set-up and the individual leads through the night. Children with neurodisability were compared to neurotypical children and sub-analyses were conducted related to particular sub-groups (e.g. Trisomy 21). RESULTS: 132 children with neurodisability and 139 neurotypical children underwent diagnostic PSG. Mean age was 8 years, 50% had a sleep disorder identified on PSG and 39% were female, with no significant differences between the groups. The most-poorly tolerated sensor for all children was the nasal pressure transducer (poorly tolerated in 30%), followed by thermistor (14%) and EEG leads (6%). Children with neurodisability were less likely to tolerate all PSG leads (44% did not tolerate all) compared to neurotypical children (20%) [relative risk 1.8, 95%CI 1.2-1.7, p<0.05]. Children with Trisomy 21 had an increased likelihood of PSG lead intolerance (63%) compared to neurotypical children [relative risk 2.3, 95%CI 1.4-3.8 p<0.05]. CONCLUSION: This retrospective study demonstrates that children with neurodisability are less likely to tolerate PSG monitoring than neurotypical children and highlights the need to develop alternative measures for evaluation of SDB in this population.