title: Sleep studies in children on long-term non-invasive respiratory support.
abstract: OBJECTIVE
  The aim of this study was to assess the impact of changes in respiratory support (RS) settings recommended after a titration polysomnography (PSG), in terms of daytime symptoms and quality of life.
  
  
  METHODS
  A retrospective chart review of all RS (CPAP and bi-level ventilation) titration studies was carried out at our tertiary paediatric sleep laboratory in the past 5 years. All patients with at least two studies in the past 5 years were included in the analysis. Parents completed the obstructive sleep apnoea (OSA)-18 and Paediatric Daytime Sleepiness Scale (PDSS) questionnaires on the night of each PSG. Results are presented as means (SD).
  
  
  RESULTS
  A total of 42 patients (25 on CPAP and 17 on bi-level ventilation, age 11 (6) years) had 71 pairs of titration studies (41 CPAP and 30 bi-level). Changes in RS settings were recommended in 27 of 41 (65%) CPAP studies and 11 of 30 (36%) bi-level studies. Overall, changes were fully implemented by the treating physician in 55% of cases. There was an improvement in total OSA-18 score between studies in 48% of the paired CPAP studies and 65% of bi-level studies. OSA-18 scores improved in 47% of the studies where any recommended change had been implemented versus 0% of those where none of the recommended changes had been made (p=0.1).
  
  
  CONCLUSIONS
  Titration studies frequently led to recommendations for a change in RS settings in these patients on long-term RS. Symptom scores were more likely to improve if recommendations for change were implemented by the time of the follow-up study.
authors.affiliation: Melbourne Children's Sleep Centre, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC, 3168, Australia.
authors.forename: John A
authors.initials: JA
authors.lastname: Widger
authors.forename: Margot J
authors.initials: MJ
authors.lastname: Davey
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Nixon
mesh_terms: D000293:Adolescent; D002648:Child; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D017286:Polysomnography / Q000379:methods*; D011788:Quality of Life / Q000523:psychology; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires