0926 Successful Completion of Polysomnography in Children with Neurodivergence and Anxiety with Use of an Individualized Desensitization Protocol

Abstract Introduction Children with autism, sensory processing difficulties, and anxiety often have challenges tolerating polysomnography (PSG) – the gold standard for diagnosing sleep-disordered breathing. The extensive hook-up is often poorly tolerated, contributing to patient and familial stress, increased likelihood of early study termination, and insufficient sleep time and data. Behavioral desensitization prior to PSG can reduce fear responses to medical stimuli and improve tolerance. This project aimed to assess PSG sleep architecture parameters in children with neurodivergence and anxiety after undergoing a desensitization protocol by sleep psychology. Methods Children ages 2-17 years with autism, sensory processing disorder, anxiety disorders, and fear of other medical care were included. Demographic and PSG data were collected from the medical record on patients referred to sleep psychology who underwent desensitization. The desensitization protocol incorporated principles of behavioral reinforcement and graduated exposure to increase patients’ tolerance of wearing PSG materials (electroencephalography, nasal cannula, pulse oximetry, head wrap, respiratory belts). Interventions included psychoeducation, social story video, and structured sensory exploration of materials. Interventions and number of sessions were individualized based on age, co-morbidities, and needs. Psychologists monitored distress, taught adaptive coping, provided behavioral reinforcement, and encouraged practice with sensory substitutions between desensitization appointments. Prior to PSG, psychologists communicated the child’s progress and effective coping strategies to sleep technologists to facilitate successful study completion. Results Our cohort ( total 29 patients) constituted 59% males, 41% females, a mean age of 10 years, 48% patients with autism, 7% with sensory processing disorder, and 59% with an anxiety disorder or fear of medical care. With desensitization, 96% patients achieved valid polysomnography duration and data, enabling a diagnosis to be made. The median total sleep time was 409 minutes. The median sleep efficiency was 85%. Forty-eight percent of children demonstrated sleep efficiency greater than 85%. Fifty-nine percent of children achieved all sleep stages. Average N3 sleep was 34%. Sleep onset latency was variable (mean 45 minutes, range 246 minutes). Conclusion This study demonstrates that successful completion of PSG (sufficient sleep duration, sleep efficiency, and sleep architecture) is achievable – even in children with neurodivergence or anxiety – after undergoing an individualized desensitization protocol. Support (if any)