Eric Pease, Julia Shekunov, Samuel T. Savitz, Raphael Golebiowski, Vanessa Dang, Jake Arbon, Andrew Pines, Robin Lloyd, Julie Baughn, Magdalena Romanowicz

Chronic disruptions to sleep in childhood are associated with increased prevalence of psychiatric disease later in development. When sleep disruptions remit before adolescence, the increased prevalence of psychiatric disease is no longer observed, highlighting the importance of early detection and intervention. Clinicians typically rely on caregiver report for diagnosis and management of childhood sleep challenges. We examined if findings on polysomnogram (PSG) can offer similar insight into childhood sleep difficulties and the risk of subsequent psychiatric illness. A cohort was identified of 348 children ages 5 years 11 months and younger with sleep difficulties rising to the level of formal clinical workup. A retrospective review of caregiver reported sleep concerns, polysomnogram (PSG) results, and subsequent psychiatric illness was completed. PSG findings were compared to presence of psychiatric illness later in life as well as caregivers' reported concerns. Chi-square and Fisher's exact tests were completed to evaluate correlations and Cohen's kappa was used to evaluate agreement. With only a few exceptions, comparisons between clinician findings on PSG and subsequent psychiatric diagnoses were statistically nonsignificant. Similarly, the relationship between caregivers' subjective complaints about sleep and clinician findings on PSG demonstrated only slight to fair agreement, suggesting reported concerns were not predictive of PSG results. Parental reports of subjective sleep concerns are indicative of different sleep pathologies compared to sleep pathologies detected on PSG. The addition of PSG to caregiver reported data appears to have limited clinical utility in understanding sleep concerns associated with the risk of subsequent psychiatric illness in young children.