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Technologies in the Pediatric Sleep Lab: Present and Future

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Pediatric Sleep Medicine

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Abstract

Assessing sleep in children is challenging. While polysomnography (PSG) remains the gold standard test in laboratory, many times it has been difficult to perform polysomnography in small children. They tend to remove the electrodes and thus the failure rate of PSG in children is relatively high. Furthermore, in pediatric obstructive sleep apnea (OSA), sometimes the single laboratory finding is hypercapnia, and hence measuring CO2 is also required, which may even increase the failure rate. In addition, PSG (regardless of CO2) is relatively complex and is disadvantageous when children need several consecutive nights of assessments. Some newer technologies such as pulse transit time, sophisticated computerized analyses of ECG, or peripheral arterial tonometry are validated when assessing sleep in adults and are in various stages of development/research for usage in children (in the home environment). Other technologies such as actigraphy are excellent for children, including longitudinal assessment of nights-weeks, but the data provided are limited compared to PSG. Some even newer technologies such as snoring sound analyzers, wearable activity trackers, or even smartphone applications may open the horizon for simpler sleep assessments in children at home, although the science and data in this regard are still insufficient. This chapter deals with various technologies, reports their advantages and disadvantages, and attempts to foresee the future for sleep assessment in children.

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Abbreviations

BMI:

Body mass index

CO2:

Carbon di Oxide

ECG:

Electrocardiogram

EEG:

Electroencephalogram

EMG:

Electromyogram

EOG:

Electrooculogram

ETCO2:

End-tidal CO2

FFT:

Fast Fourier transformation

HF:

High frequency

HRV:

Heart rate variability

HSAT:

Home sleep apnea test

LF:

Low frequency

OAHI:

Obstructive apnea hypopnea index

OSA:

Obstructive sleep apnea

PAT:

Peripheral arterial tonometry

PSG:

Overnight polysomnography

PTT:

Pulse transit time

SDB:

Sleep disordered breathing

SE:

Sleep efficiency

SL:

Sleep latency

SpO2:

Arterial pulse oxygen saturation

TCCO2:

Transcutaneous CO2

TST:

Total sleep time

VLF:

Very low frequency

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Authors and Affiliations

  1. Department of Pediatrics, Carmel Medical Center, Haifa, Israel

    Tamar Etzioni-Friedman

  2. Department of Pediatrics and Sleep Clinic, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel

    Giora Pillar

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  1. Tamar Etzioni-Friedman
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  2. Giora Pillar
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  1. MU Women’s and Children’s Hospital, University of Missouri, Columbia, MO, USA

    David Gozal

  2. Child Health Research Institute, University of Missouri System, Columbia, MO, USA

    Leila Kheirandish-Gozal

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Etzioni-Friedman, T., Pillar, G. (2021). Technologies in the Pediatric Sleep Lab: Present and Future. In: Gozal, D., Kheirandish-Gozal, L. (eds) Pediatric Sleep Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-65574-7_15

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