Factors affecting polysomnography compliance and delays to surgical treatment of obstructive sleep apnea.

John Sommerfeldt, Alexander Duffy, Conor Blanco, Caroline M Kolb, Cecilia Freeman, Nicole L Aaronson
Author Information
  1. John Sommerfeldt: Department of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, 96859, USA.
  2. Alexander Duffy: Department of Otolaryngology - Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA.
  3. Conor Blanco: RWJ Barnabas and Summit Health, NJ, USA.
  4. Caroline M Kolb: Department of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, 96859, USA.
  5. Cecilia Freeman: St. Luke's Health Network, USA.
  6. Nicole L Aaronson: Division of Pediatric Otolaryngology, Nemours Children's Health, Wilmington, DE, 19803, USA; Department of Otolaryngology - Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA. Electronic address: nicole.aaronson@nemours.org.

Abstract

OBJECTIVE: To evaluate adherence to polysomnography in pediatric patients and determine if demographics, socioeconomic status, polysomnography indication, or prior otolaryngology intervention are associated with polysomnography adherence and time to definitive surgery.
STUDY DESIGN: Retrospective review study.
SETTING: Tertiary-care children's hospital.
METHODS: Electronic medical record was queried to identify patients ordered for a sleep study between January and May 2019. Demographic information, time to sleep study, and time to surgery were collected and calculated.
RESULTS: 304 patients were recommended to obtain polysomnography, with adherence rate of 65.4%. There was no significant difference in adherence or loss to follow-up rates based on patient sex, age, language, socioeconomic status, state of residence, single-parent status, or polysomnography indication. There was no difference between time to surgery for patients who did or did not obtain polysomnography (181 vs. 161 days, P = .51). patients with prior otolaryngology intervention were more likely to obtain polysomnography and less likely to be lost to follow-up (P < .05). Median household income demonstrated a significant inverse relationship with time to polysomnography (P < .05) as well as time to surgery (P < .05). Medically complex patients tended to experience longer time to surgery compared with non-complex patients.
CONCLUSION: Families with lower socioeconomic status or medically complex children may require assistance to obtain polysomnography and pursue surgery for sleep-disordered breathing. patients without prior otolaryngology intervention may be less likely to follow up and may need assistance with navigating the polysomnography process.

Keywords

MeSH Term

Child
Humans
Polysomnography
Sleep Apnea, Obstructive
Sleep Apnea Syndromes
Retrospective Studies
Otolaryngology

Word Cloud

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