Background

Families of children with complex co-morbidities have a huge treatment burden, which could be helped by delivering as much care at home as possible but data on home sleep studies are limited.

Aims

To determine the technical success rate and if clinical decisions changed after a home study.

Methods

We collected data on home O2/CO2 and cardiorespiratory polygraphies (CRSS) done June 2021- November 2022 in patients with neurodisabilities. If patients had >1 home study in this period, only the first one was considered.

Results

We analysed 48 studies: 25(52%) on no respiratory support, 1(2%) on CPAP, 1(2%) split BIPAP/no support, 21(44%) on BIPAP; 7(14.5 %) were tracheostomy ventilated. Median age was 12.5 years (range 1-18 years). The indications were: routine monitoring (n=28, 58.3%), change in clinical condition (n=7, 14.6%), following change in ventilator settings (n=2, 4.2%), other (n=11, 22.9%). 

42 studies (87.5%) were successful:7 of 8 O2/CO2, 35 of 40 CRSS.

21 patients on CPAP/BIPAP had successful home studies; settings were changed in 5 (IPAP, back up rate or >1 change) and mode of ventilation was changed in 2.

Conclusion

Home sleep studies in patients with neurodisabilities have a high success rate and can be used for routine monitoring and guiding changes in ventilation (33% in those on CPAP/BIPAP).They reduce the burden of hospital admissions and are likely more representative of a typical night's sleep.