title: Trends in Inpatient Pediatric Polysomnography for Laryngomalacia and Craniofacial Anomalies.
abstract: OBJECTIVE
  Increasingly, laryngomalacia and craniofacial anomalies are recognized as risk factors for obstructive sleep apnea. We sought to determine whether children with these diagnoses have become more likely to undergo inpatient polysomnogram (PSG) over time and to identify evolving trends in PSG utilization.
  
  
  METHODS
  Retrospective analysis of the Kids' Inpatient Database from 2003 to 2012. Children <21 years who underwent PSG were included. Weighted comparisons of clinical/demographic characteristics of patients undergoing PSG were performed, as were associations between clinical and demographic patient characteristics and performance of inpatient PSG.
  
  
  RESULTS
  Between 2003 and 2012, PSG procedures decreased from 1266 to 829 (P < .001). Among children who underwent PSG, mean age decreased from 3.9 ± 5.1 to 3.1 ± 5.2 years (P = .001), and the frequency of age <1 year increased from 47.8% to 59.5% (P < .001). The frequency of laryngomalacia increased from 2.5% to 14.3% (P < .001), while the frequency of craniofacial anomalies increased from 6.2% to 19.4% (P < .001). Laryngomalacia and craniofacial anomalies were predictive of undergoing inpatient PSG in both timeframes.
  
  
  CONCLUSIONS
  Despite decreasing PSG volumes, diagnoses of laryngomalacia and craniofacial anomalies comprised increasing fractions of children undergoing inpatient PSG between 2003 and 2012. Laryngomalacia and craniofacial anomalies were also predictive of inpatient PSG use in both timeframes.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
authors.forename: Kareem O
authors.initials: KO
authors.lastname: Tawfik
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Ahmad R
authors.initials: AR
authors.lastname: Sedaghat
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA Cincinnati Children's Hospital Medical Center, Divisions of Otolaryngology-Head & Neck Surgery and Pulmonary Medicine, Cincinnati, Ohio, USA stacey.ishman@cchmc.org.
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Ishman
mesh_terms: D002648:Child; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D055092:Laryngomalacia / Q000150:complications*; D008297:Male; D017286:Polysomnography / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology
keywords: Kids’ Inpatient Database; craniofacial anomalies; laryngomalacia; pediatric obstructive sleep apnea; polysomnography; sleep disordered breathing