Home video clips compared to polygraphy for obstructive sleep apnea diagnosis in children with autism spectrum disorder: A pilot study.

Researchers tested whether home videos could help identify sleep breathing problems in autistic children. Parents recorded short videos of their children sleeping at home, which were then scored for signs of sleep apnea. The video method caught all cases of moderate-severe sleep apnea but also flagged many children who didn't have serious problems. While promising as an easier screening tool than hospital sleep studies, more research is needed to improve accuracy.

This pilot study evaluated home video clips as a screening tool for obstructive sleep apnea (OSA) in children with autism spectrum disorder (ASD). Twenty-six children aged 4-18 years underwent home polygraphy testing, with 15 providing home video recordings. Parents recorded 3 two-minute videos which were scored using the Monash score. Results showed the video-based Monash score achieved 100% sensitivity but only 63.6% specificity for detecting moderate-severe OSA (≥5 events/hour).

While the Monash score outperformed standard questionnaires and some oximetry measures, it did not exceed oxygen desaturation index performance. The study suggests home video clips may offer a more accessible screening alternative to traditional sleep studies for children with ASD, though further validation is needed.

Home video screening may offer a more accessible alternative to traditional sleep studies for children with ASD, potentially improving OSA detection rates. However, current low specificity limits clinical utility and may lead to unnecessary referrals. Further research needed before clinical adoption.

Very small sample size (26 participants, only 15 with videos), pilot study design, lack of comparison with gold-standard polysomnography, single-site recruitment. Results require validation in larger, more diverse samples before clinical implementation.

Children with autism spectrum disorder (ASD) have higher prevalence of obstructive sleep apnea (OSA) than typically developing children. Polysomnography (PSG), the gold standard test is challenging for children with ASD. Polygraphy (PG) may be better tolerated, but more accessible screening tools are needed. We evaluated diagnostic characteristics of video clips for OSA in this pilot study.

Children 4-18 years with ASD referred for PSG for suspected OSA were recruited. Parents recorded 3 2-min home videos, scored for OSA presence using Monash score (MS, positive if ≥ 3). Participants completed the Pediatric Sleep Questionnaire (PSQ; positive if ≥ 0.33) and underwent home PG, scored by obstructive apnea hypopnea index (oAHI), oxygen desaturation index 3 % (ODI3; ≥4.3 and > 7 thresholds) and McGill Oximetry Score (MOS; positive if ≥ 2). Receiver-operator curves were used to compare diagnostic performance across tools for moderate-severe OSA (oAHI ≥5 events/hour). 26 children participated; 15 (median age 7.1) provided video clips.

Median oAHI was 2.4/hr; 26.7 % had moderate-severe OSA. Fourteen (93.3 %) had PSQ ≥0.33, three had MOS ≥2. ODI3 was ≥4.3 in 7 and > 7 in 6 children. Median MS was 3.0.

MS had 100 % sensitivity, 63.6 % specificity and AUC 78.4 for detecting moderate-severe OSA; average AUC increased when MS was combined with oximetry metrics. MS showed high sensitivity but low specificity in detecting moderate-severe OSA. MS outperformed PSQ and MOS, but not ODI3. MS may be a viable alternative screening tool to identify OSA in children with ASD but requires further validation.