Diagnostic outcomes between home sleep apnoea testing and in-laboratory polysomnography: systematic review

Introduction
Paediatric sleep-disordered breathing is a relatively common condition that has significant neurocognitive and medical implications for children. The gold standard investigation for diagnosis is in-laboratory polysomnography however this is very labour intensive. Home sleep apnoea testing for the investigation of paediatric sleep-disordered breathing have been investigated in recent years and may help address this issue but there have been no recent systematic reviews providing information on the outcomes of these devices in children.

Aims
To assess the concordance and correlation of outcomes between home sleep apnoea testing devices and in-laboratory polysomnography in the diagnosis of paediatric sleep-disordered breathing.

Method
Systematic review in accordance with PRISMA guidelines. A comprehensive search between June 2021 - June 2022 was performed. Data sources included bibliographic databases (MEDLINE, Embase, Web of Science), Cochrane library and Grey literature. Clear restrictions were applied and quality assessment was performed using the Cochrane ROBINS-1 tool, CASP tool and Joanna Briggs Institute checklist to determine included studies.

Results
10 articles were included in the systematic review covering 724 patients and six different devices. There was a high degree of concordance and correlation in the diagnostic outcomes between the home sleep apnoea testing and in-laboratory polysomnography.

Conclusion
Home sleep apnoea testing devices show a moderate-high degree of agreement with in-laboratory polysomnography outcomes. The sensitivity and specificity of these portable devices tend to be lower than in-laboratory polysomnography but may be sufficient for use as rule-out tests in specific patient populations.