Towards Patient-centered Diagnosis of Pediatric Obstructive Sleep Apnea-A Review of Biomedical Engineering Strategies

Introduction: Obstructive sleep apnea in children has a prevalence of 5%. Polysomnography is considered to be the gold standard for diagnosis and stratification of the condition. However, it is resource-intensive, expensive and uncomfortable for children and their families.Areas covered: We focus this review on technical developments in sensor technology, materials and predictive analytics for translation to (i) patient comfort and compliance in the laboratory and (ii) validation of home sleep apnea testing in children. Key developments in adult polysomnography that could be considered for adoption in children are also highlighted. This review is organized by Sleep, Cardiovascular, Oximetry, Position, Effort, and Respiratory (SCOPER) parameters of interest.Expert opinion: In the past decade, improvements in respiratory sensors and signal processing strategies have transitioned sleep apnea testing in adults from the laboratory to home, thus reducing costs and improving access. Unfortunately, such benefits have not been observed for children principally due to the lack of high-quality studies. The increasing cost of diagnosis of sleep apnea in children needs urgent attention. Recent technical developments as described in this review have the potential to support further evaluation of home sleep apnea testing while improving the current circumstances of in-lab polysomnography for children.