Mandibular Movement Monitoring in Children With Neurodisability

BACKGROUND: Obstructive sleep apnoea (OSA) in children is diagnosed using polysomnography (PSG), but children with neurodisability are >3 times more likely to not tolerate leads and sensors. The diagnostic accuracy of Sunrise, a small sensor applied to the chin, has not been assessed in this special population. OBJECTIVE: Compare the diagnostic accuracy of Sunrise to simultaneously recorded in-laboratory PSG. METHODS: We conducted a prospective, cross-sectional study of children aged 3-18 years with neurodisability, who attended the Queensland Children's Hospital sleep laboratory for diagnostic PSG between February 2024 and September 2025. Sunrise- and PSG-derived measures of sleep disordered breathing were compared, and questionnaire data examining interest in novel sensor technology, and portable, home-based sleep studies were also collected. RESULTS: There were 48 children with a neurodisability (mean [SD] age = 11.2 [3.6]; 39% female). For 43 children with complete Sunrise data, sensitivity and specificity for identifying moderate-severe obstructive sleep apnoea (OSA) using calibrated MM-ORDI were 0.88 (95% CI: 0.45-1.00) and 0.63 (95% CI: 0.45-0.79), respectively. The concordance correlation coefficient of the obstructive respiratory disturbance index was 0.65 (95% CI: 0.5-0.8) and the median absolute error was 5.7 (IQR: 2.7-13.1) events per hour. Most carers in attendance preferred in-laboratory sleep studies (56%) to home (33%), but the majority preferred Sunrise (50%) to limited-channel (17%) or full PSG (10%). CONCLUSION: Sunrise shows excellent ability to exclude moderate-severe OSA in children with neurodisability with moderate specificity. There is substantial appetite among parents and carers for alternative sleep testing modalities.