0725 Characteristics Of Pediatric Populations Evaluated For Sleep Disorders In Pediatric Hospital Clinics

Abstract

Introduction: Pediatric sleep problems range from 25% to 40%, with increased presence for chronic-medical disorders (Owens, 2005). In-lab sleep studies are essential for accurate diagnosis and subsequent treatment for pediatric sleep disorders. The presence of co-morbid medical disorders may impact the administration of sleep studies due to patients' sensory issues, medical symptoms, or neuro-cognitive abilities. Often sleep studies are discontinued and patients required to return for additional testing which is costly, time-consuming, and may lead to delays in treatment. Given this, we are interested in the general characteristics of patients evaluated for sleep disorders in children's hospital sleep clinics to optimize the evaluation and subsequent treatment of sleep disorders among medically-complex, pediatric populations. Methods: We retrospectively reviewed the charts of 179 patients ages 4 to 18-years-olds over a 4-month period. Patients were categorized as medically non-complex (ex. asthma, enlarged tonsils) or medically-complex (multiple active diagnoses ex. neurodevelopmental, epilepsy, cardiac). We analyzed the following variables: age, ethnicity, height, weight, BMI, diagnoses, total sleep time (TST), sleep onset latency (SOL), and sleep efficiency (SE). Results: More medically-complex patients were evaluated (73%) than non-complex (26%). Gender rates were equal in both groups. Of medically-complex patients evaluated, most had a neurodevelopmental (44%) in contrast to muscular degenerative (2%) disorders. When accounting for age and BMI, non-complex patients had significantly longer TST (M=406.45min, SD=80.2) than complex patients (M=377.2min, SD=115.1, F(3,170)=3.27, p =.023). A significant association between patients and positive obstructive sleep apnea (OSA) diagnosis was present, with 2.22 times higher odds of diagnosis for medically-complex patients. No other variables were significant. Conclusion: In a pediatric hospital outpatient clinic, the majority of patients evaluated for sleep disorders were medically complex. They had lower TST and increased odds of OSA diagnosis than non-complex patients. Although medical etiologies are broad, results from this series of analyses may provide guidance for best sleep study procedures for complex pediatric patient populations in order to optimize the diagnosis and treatment of potential sleep disorders.