SLEEP 2026 | Improving patient safety in pediatric sleep laboratories

I think with the advent of home studies, many simpler patients are going to have sleep studies at home, so many more patients who are chronically either sick or have low physiological results are coming to the sleep lab because of the awareness of sleep without breathing in the long-term symptoms and outcomes. So we are testing more and more patients who are sick. Number two, many sleep labs are located out of the main campus. Number three, the technologists are not trained to evaluate clinically and handle the patients. They just know how to collect the data for the sleep studies. Number four, there is no sleep nurse if there is a deterioration in the event, so they can identify and take care of patients. And number five is ongoing education and quality improvement, mortality and morbidity conferences, QI initiatives are lacking in many of the sleep labs. So hence, to build a robust sleep safety culture, it’s important that everybody’s on the same page. Starting from patient selection, a robust triage system that determines which patients are safe to go to a hospital sleep lab versus inpatient sleep study versus a sleep study at a remote location with limited resources. Number two, how you are prepared based on the risk of these patients can have at night. Number three, what kind of nursing and respiratory support this patient needs overnight, so that you’re prepared for that. Number four, teaching the technologists and training them with simulation hands-on for pattern recognition, that if this pattern is appearing on the PSG, that they should be much more aware and approach the patient for a safety perspective. Number five, how do you do mock drills, you know, if there is a safety event, how are you going to act, so simulating mock drills is an important aspect of sleep lab safety. And number six is ongoing education, onboarding, training the physicians huddle at the beginning of the night, so that each patient is discussed just before the sleep study and have a clear plan during the night, and subsequently admission policies. If the patient is sick during the sleep study or has a severe degree of sleep apnea, what patient needs to be admitted for immediate therapy are also an important part of the thing. So having those processes set in, reviewing your policies, making sure that you’re accredited from the American Academy of Sleep Medicine, JCAHO, other regulatory organizations to make sure that your safety culture is pretty robust and constantly changing and improvising based on the ongoing challenges. So these are, I think, at the least, the most important factors that affect pediatric sleep lab safety.

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