远程医疗支持的 2 级儿科家庭多导睡眠图。
Telehealth-supported level 2 pediatric home polysomnography.
机构信息
Sleep Unit, Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia.
Murdoch Children's Research Institute, Melbourne, Australia.
出版信息
J Clin Sleep Med. 2022 Jul 1;18(7):1815-1821. doi: 10.5664/jcsm.9982.
STUDY OBJECTIVES
The gold standard for diagnosis of pediatric obstructive sleep apnea (OSA) is level 1 polysomnography (PSG). At our centre, some children are selected for unattended level 2 home sleep apnea testing (HSAT) with telehealth support, and we sought to review this home service.
METHODS
A retrospective audit was conducted from 2013 to 2020. All level 2 HSAT reports in children aged 5-18 years referred for suspected OSA were analyzed. American Academy of Sleep Medicine-compliant portable PSG acquisition equipment with electroencephalogram was used. The primary outcome was the proportion of technically successful tests achieved, and of these, the percentage with potential underestimation of diagnostic category. Secondary outcomes included sleep quality and parental acceptance by nonvalidated service-specific questionnaire. Data were analyzed using descriptive and inferential statistics. χ tests were used for categorical variables.
RESULTS
There were 233 (139 male, 59.6%) patients studied between 2013 and 2020 (7 years). The mean age was 10.8 (standard deviation 3.6) years. Sixty-seven patients (28.8%) had comorbidities. Technically successful studies were obtained in almost 90% (209/233) and failed studies occurred in just over 10% (24/233). One failed study still achieved a diagnosis. There was no significant difference between failed studies set up by hospital-in-the-home nurses compared with sleep scientists ( = .2). Overall, an accurate diagnosis was made in 80% (167/209) of patients, with potential for underestimation in 20% (42/209). Six hours or more of sleep was obtained in 89.5%. Parental questionnaires revealed 89.3% perceived high-level care, 91% perceived increased convenience, and 76% perceived good/excellent telehealth support.
CONCLUSIONS
Telehealth-supported pediatric HSAT achieves technical success in almost 90% of patients investigated for OSA, with 89.5% achieving ≥ 6 hours sleep duration and excellent family acceptability.
CITATION
Griffiths A, Mukushi A, Adams A-M. Telehealth-supported level 2 pediatric home polysomnography. . 2022;18(7):1815-1821.
研究目的
儿科阻塞性睡眠呼吸暂停（OSA）的诊断金标准是 1 级多导睡眠图（PSG）。在我们中心，一些儿童被选择进行无人值守的 2 级家庭睡眠呼吸暂停测试（HSAT），并辅以远程医疗支持，我们对该家庭服务进行了回顾性审查。
方法
回顾性审核从 2013 年至 2020 年进行。对所有因疑似 OSA 而转介的 5-18 岁儿童的 2 级 HSAT 报告进行分析。使用符合美国睡眠医学学会标准的便携式脑电图 PSG 采集设备。主要结局是技术上成功测试的比例，其中包括潜在低估诊断类别的比例。次要结局包括睡眠质量和父母通过非验证的特定服务问卷的接受程度。使用描述性和推断性统计数据进行数据分析。对于分类变量，使用 χ 检验。
结果
2013 年至 2020 年（7 年）期间共对 233 名（男 139 名，59.6%）患者进行了研究。平均年龄为 10.8（标准差 3.6）岁。67 名患者（28.8%）有合并症。近 90%（209/233）的研究获得了技术上的成功，仅超过 10%（24/233）的研究失败。一项失败的研究仍做出了诊断。由医院内护士与睡眠科学家设置的失败研究之间没有显著差异（ =.2）。总体而言，80%（167/209）的患者做出了准确的诊断，20%（42/209）的患者可能存在低估。89.5%的患者获得了 6 小时或更长的睡眠时间。家长调查问卷显示，89.3%的人认为得到了高水平的护理，91%的人认为增加了便利性，76%的人认为远程医疗支持良好/优秀。
结论
远程医疗支持的儿科 HSAT 在近 90%的 OSA 患者中获得了技术成功，89.5%的患者获得了≥6 小时的睡眠时间，且家庭接受度极高。
引文
Griffiths A，Mukushi A，Adams A-M。远程医疗支持的 2 级儿科家庭多导睡眠图。. 2022；18（7）：1815-1821。
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