Why who

• To confirm the diagnosis, define the extent and severity and to help with management decisions as well as to evaluate the success of managemen

• To help determine the extent of surgery required

• To ensure that the risks involved with surgery are justified by a confirmed diagnosis of obstructive sleep apnea syndrome since the risks/complications are not minimal

• To differentiate primary snoring from respiratory events related to arousals/obstructive sleep apnea syndrome

• To better evaluate cause of sleep fragmentation. Differentiate sleep fragmentation related to sleep disordered breathing from sleep fragmentation related to either movement disorders in sleep or nocturnal seizures

• To evaluate and rule out nocturnal seizures as a cause of sleep parasomnias, sleep disordered breathing or apparent movement disorders in sleep

• Diagnostic sleep polysomnogram should be part of the diagnostic algorithm prior to considering surgery in patients with suspected obstructive sleep apnea syndrome

• Children with snoring and suspected obstructive sleep apnea syndrome

• Children with complaints of sleepiness/tiredness and a history of inattentiveness, fidgeting and/or behavioral problems

• Children with complaints of restless sleep with or without snoring

• Children with witnessed cessation of breathing in sleep
-Note that cessation of breathing may represent obstructive or central apnea and as such need to be differentiated by polysomnography

-The absence of a history of cessation of breathing does not rule out obstructive sleep apnea syndrome as the definition of apnea is 2 respiratory cycles in children so depending on age this may range from 3-20 second depending on the age of the patient.

• Children with complaints of excessive daytime sleepiness

• Children with obesity, snoring and complaints of disrupted or difficulty sleeping

• Children with neuromuscular disease such as Duchenne Muscular Dystrophy

• Children with excessive daytime sleepiness, narcolepsy or hypersomnia

• Children with sleep parasomnias such as sleep terrors, with a history of possible disrupted breathing while sleeping

• Patients with suspected nocturnal seizures. Example: teenage onset sleepwalker