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How to interpret polysomnography
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  • Michael D Farquhar (lead co-author), Don Urquhart (co-author), Kylie Russo (co-author), Francois Abel (co-signatory), Heather Elphick (co-signatory), Neil Gibson (co-signatory), Paul Gringras (co-signatory), Catherine Hill (co-signatory), Desaline Joseph (co-signatory), (Dr) Ruth Kingshott (co-signatory), Jane Orgill (co-signatory), Omendra Narayan (co-signatory), Martin Samuels (co-signatory) and Hui-leng Tan (co-signatory)
    Published on:
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    Response to "How to interpret polysomnography": A UK Perspective
    • Michael D Farquhar (lead co-author), Consultant, Paediatric Sleep Medicine Evelina London Children's Hospital
    • Other Contributors:
      • Don Urquhart (co-author), Consultant, Paediatric Respiratory and Sleep Medicine
      • Kylie Russo (co-author), Chief Sleep Physiologist
      • Francois Abel (co-signatory), Consultant, Paediatric Respiratory and Sleep Medicine
      • Heather Elphick (co-signatory), Professor/Consultant, Paediatric Respiratory and Sleep Medicine
      • Neil Gibson (co-signatory), Consultant, Paediatric Respiratory Medicine
      • Paul Gringras (co-signatory), Professor/Consultant, Paediatric Sleep Medicine
      • Catherine Hill (co-signatory), Consultant, Paediatric Sleep Medicine
      • Desaline Joseph (co-signatory), Consultant, Paediatric Sleep Medicine
      • (Dr) Ruth Kingshott (co-signatory), Sleep Physiologist
      • Jane Orgill (co-signatory), Principal Sleep Physiologist
      • Omendra Narayan (co-signatory), Consultant Respiratory Paediatrician, Clinical Lead for Sleep Medicine
      • Martin Samuels (co-signatory), Consultant Respiratory Paediatrician
      • Hui-leng Tan (co-signatory), Consultant, Paediatric Respiratory and Sleep Medicine

    We read with interest the article by Leong et al. on the use of polysomnography (PSG) in children (Leong et al. 2019), covering indications for PSG, along with limitations of oximetry, and clearly outlining how to undertake and interpret polysomnography in paediatric patients. It briefly discusses limited channel recordings (respiratory polygraphy, RP) and concludes that this ‘is not standard practice’.

    In many paediatric centres RP is standard practice, and routinely used for assessment of sleep-disordered breathing (SDB) in children, with the most common diagnosis being obstructive sleep apnoea (OSA).

    In a recent survey of 20 United Kingdom and Republic of Ireland paediatric sleep centres (Russo, 2017), all centres reported use of RP for diagnosis of SDB, with 14 centres using this as the main diagnostic method. PSG was performed in 10 centres, contributing a small part of workload (median of total workload: 5% (range: 1%-15%)). The majority of all studies were performed within a hospital setting, with home oximetry/RP use reported in 25% of centres. Indeed, the UK has led the way in home RP (Kingshott 2019). As international leaders in the field acknowledge, ‘the times they are a changing.’ (Gozal 2015)

    RP utilises measures of airflow, respiratory effort by inductance plethysmography bands, oxygen saturation, carbon dioxide and heart rate monitoring. This allows accurate detection and discrimination of obstructive, central and mixed apnoeas/hypop...

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    Conflict of Interest:
    None declared.