Tolerance of esophageal pressure monitoring during polysomnography in children.

OBJECTIVES To assess tolerance of esophageal pressure monitoring (EPM) among 5- to 13-year-old children during research polysomnography at study entry and again 1 year later. DESIGN Prospective, observational study. SETTING University-based sleep laboratory. PARTICIPANTS Children scheduled for adenotonsillectomy or hernia repair. INTERVENTIONS None; all operations were performed for clinical indications only. RESULTS Forty-two of 336 families approached about the study declined to participate mainly to avoid EPM. The EPM was usually the main concern for the 47 adenotonsillectomy and 7 hernia-repair patients and families who did participate. Among 54 enrolled subjects, 51 allowed attempts at insertion of the esophageal catheter, and insertion was successful in all cases; 38 tolerated EPM for at least 2 hours; 33 maintained EPM for the entire night; and 36 had repeat EPM 1 year later for at least 2 hours. Reasons for EPM failure included crying at insertion, vomiting, pain, and inadvertent catheter removal during sleep. The children who tolerated EPM for at least 2 hours did not differ from other subjects based on age, sex, presence of a disruptive behavior disorder, anxiety, tonsil size, history of tonsillitis, or body mass index (all P > .05). CONCLUSIONS The EPM was well tolerated in most school-aged volunteers, but many families did not volunteer, and some children were not able to endure EPM for at least 2 hours. Although better success might be achieved in clinical settings if EPM is medically indicated and not part of voluntary research, EPM is still likely to create significant concern, for children and parents, that must be weighed against anticipated benefits.