P014 Sweet dreams at home: reviewing paediatric domiciliary sleep studies

Abstract Traditional in-laboratory level 1 polysomnography (PSG) remains the gold standard for diagnosing paediatric sleep-disordered breathing (SDB) and obstructive sleep apnoea (OSA). However, this method presents significant barriers, including long waitlists, limited accessibility for rural families, and burdensome hospital stays. In contrast, domiciliary sleep studies have become widely adopted in adult populations, but similar uptake in paediatrics remains limited due to a lack of robust validation and standardisation. This review explores the current evidence for domiciliary sleep studies in children, highlighting their potential to enhance timely diagnosis and management of SDB while also exploring areas for improvement. A structured MEDLINE search identified 16 key articles exploring various home-based diagnostic methods: level 1–4 PSG, pulse oximetry, transcutaneous CO₂ monitoring, as well as novel commercial devices. Results suggest that while home-based PSG (level 2) shows high feasibility and parental preference, simpler modalities like pulse oximetry and level 4 PSG often underdiagnose due to limited apnoea detection. Commercial devices, though better tolerated, demonstrated reduced diagnostic accuracy. Critical themes discussed include parental compliance, device accuracy (especially apnoea–hypopnoea index measurement), and implementation challenges. Recommendations include multi-night testing, minimising equipment complexity, involving trained technicians or providing thorough parental education, and refining device sensitivity. This review underscores the need for further paediatric-specific validation of home-based sleep study technologies. Optimising domiciliary sleep diagnostics may alleviate healthcare bottlenecks and improve clinical outcomes for children with sleep disorders.