0877 Acceptability and Preference of Home Sleep Apnea Testing Compared with In-Lab Polysomnography in Children

Abstract Introduction In-lab polysomnography remains the diagnostic standard for evaluation of obstructive sleep apnea (OSA) in children, but is limited by cost, accessibility, and challenges of sleeping in an unfamiliar environment. Home sleep apnea testing (HSAT) may be an alternative option, yet acceptability and preference of HSAT versus polysomnography in children are unknown. This study compared parent and child-reported acceptability, usability, and preference of HSAT versus PSG following adenotonsillectomy (AT). Methods In this clinical trial, children aged 5-12 years referred for clinical polysomnography for evaluation of OSA post-AT were enrolled and randomized 1:1 to complete comprehensive HSAT with electroencephalography either before or after clinical in-lab PSG. Acceptability questionnaire data using a 5-point Likert scale to assess approval, appeal, and likability of HSAT were summarized. Parent and child responses regarding ease of HSAT use, test preference, and similarity to a typical night of sleep were compared using chi squared. Open-ended comments were analyzed for common themes regarding test experience. Results Forty-nine children participated (median age 9.9 years; 24 [49%] female). Regarding HSAT acceptability, 87% agreed it “met approval”, 77% found it “appealing”, and 81% “liked it”. Parent preferences were evenly split (49% HSAT, 49% PSG), though most reported HSAT resembled a more typical night (71% versus 20%, p< 0.0001) and was easier (57% versus 35%, p=0.0018). Children tended to prefer PSG (57% versus 39%, p=0.07). Similarly reported HSAT resembled a typical night (59% versus 31%, p=0.005) and ease of use (45% HSAT, 43% PSG). Qualitative comments highlighted HSAT comfort, convenience, and reduced hospital stressors, while PSG offered reassurance, technician support and perceived thoroughness, emphasizing real-time assistance with sensors and fewer issues with equipment removal. Conclusion Parents reported comprehensive HSAT as highly acceptable for the evaluation of OSA in children and more representative of a typical night of sleep, yet overall preferences for HSAT versus PSG were mixed, with reported trade-offs with each test. Although HSAT could be a family-centered alternative OSA evaluation in some children, the choice of test must be individualized to align diagnostic testing with family needs and preferences. Support (if any) AASM Foundation