title: Full-night versus 4h evening polysomnography in children less than 2years of age.
abstract: OBJECTIVE
  Pediatric polysomnogaphy (PSG) is associated with significant burden in terms of personnel time, resource use, and patient/family discomfort. We hypothesized that 4-h abbreviated PSG may be a suitable alternative to full-night PSG in children 24months of age and younger.
  
  
  METHODS
  PSG results from the first 4-h were compared to the full-length studies from 105 children. Outcomes included total, obstructive, and central apnea indices. Sleep disordered breathing (SDB) was defined as an apnea-hypopnea index (AHI) >1.5events/h and obstructive sleep apnea (OSA) was defined as an obstructive AHI>1.5 events/h. Cutoffs for central apneas were 3events/h for subjects >6months of age and 10events/h for subjects ⩽6months of age.
  
  
  RESULTS
  All but one subject had abnormal SDB by the full-night PSG and all individuals had at least one REM period in the first 4h of sleep. Mean oxygen saturations and end-tidal CO(2), did not significantly differ between full-night and 4-h PSG. 4-h PSG showed high sensitivity for total AHI (100% for ⩽6months and 92.9% for >6months respectively), obstructive AHI (97.9%; 91.1% respectively), and central apnea index (100%; 72.2% respectively). Agreement was lower for those with lower AHI.
  
  
  CONCLUSIONS
  The high prevalence of SDB observed suggests that the goals of PSG in this age group at our center may be to determine the type and severity of SDB rather than presence or absence. The high sensitivity between full-night and 4-h PSG supports the use of 4-h PSG in children 24months and under, especially those ⩽6months of age.
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Kahlke
authors.forename: Manisha B
authors.initials: MB
authors.lastname: Witmans
authors.forename: Tareq
authors.initials: T
authors.lastname: Alabdoulsalam
authors.forename: Rochelle
authors.initials: R
authors.lastname: Young
authors.forename: Joanna E
authors.initials: JE
authors.lastname: MacLean
authors.forename: Piush J
authors.initials: PJ
authors.lastname: Mandhane
mesh_terms: D000367:Age Factors; D002245:Carbon Dioxide / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening; D010100:Oxygen / Q000097:blood; D017286:Polysomnography / Q000379:methods*; D011237:Predictive Value of Tests; D020182:Sleep Apnea, Central / Q000175:diagnosis* / Q000453:epidemiology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen