• David Gozal, Leila Kheirandish-Gozal, and Athanasios G Kaditis.
• aSection of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, Illinois, USA bPediatric Pulmonology Unit, Sleep Disorders Laboratory, First Department of Pediatrics, University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece.
• Curr Opin Pulm Med. 2015 Nov 1; 21 (6): 563-8.

Purpose Of ReviewThe current paradigm shift in the diagnosis of sleep apnea in adults has further emphasized the urgent need for the development and validation of less inconvenient and laborious approaches than the in-laboratory nocturnal polysomnography for evaluation of children.Recent FindingsThese efforts have been primarily centered around the following: first, refinements and validation of questionnaires; second, single-channel recordings such as oximetry, airflow, or ECG; third, home-based polysomnography and polygraphy; and fourth, biomarkers. The major overall findings emanating from such studies indicate that none of the approaches provides an ideal substitute to in-laboratory nocturnal polysomnography. Conversely, many of the proposed approaches enable effective screening in a cost-effective manner, and may be particularly suitable when access to pediatric sleep medicine facilities is limited or unavailable.SummaryThe overall improvements in technologies and in our understanding of pediatric sleep-disordered breathing should enable population-tailored effective home-based diagnostic approaches that reduce the overall burden to the family, while achieving high levels of diagnostic accuracy. Newer algorithms will have to be developed and validated to allow for effective implementation of such approaches.

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