The most accurate measurement to determine OSA is level one polysomnography, which requires a night in a sleep lab connected to cords and monitors with someone watching you sleep. For a child, it can be overwhelming. It can be so uncomfortable that they are unable to sleep, making diagnosis impossible. This is where a portable sleep monitor can be very helpful. Portable sleep monitors have become much more accessible and accurate in the last few years, and now we know that they can accurately diagnose moderate to severe OSA in children.
Sleep monitoring to determine a diagnosis of obstructive sleep apnea (OSA) is done using one of the following measurement tools.
Level 1 – polysomnography or, sleep study, in a lab with more than 16 measurements. It is performed under constant supervision.
Level 2- polysomnography, without supervision.
Level 3- a sleep study can be conducted at home and requires a minimum of four measurements including at least two for respiratory movement, at least one for oxygen saturation, and one for heart rate.
Level 4 – a sleep study that is portable and measures only one or two functions. Usually, it is a pulse oximeter.
In a recent review of level three and four portable sleep monitors, researchers determined that type three portable sleep monitors can satisfactorily diagnose moderate to severe obstructive sleep apnea (OSA) in children. Type four portable sleep monitors add helpful information to a diagnosis but are not as accurate in determining sleep apnea in children.
Diagnostic accuracy of portable sleep monitors in pediatric sleep apnea: A systematic review; Vivianne Landry a 1, Koorosh Semsar-Kazerooni b 1, Tanya Chen c, Joshua Gurberg b, Lily H.P. Nguyen b, Evelyn Constantin d Sleep Medicine ReviewsVolume 78, December 2024, 101991. https://www.sciencedirect.com/science/article/pii/S1087079224000959