Which Sleep Tools Are Preferred for Children With Lennox-Gastaut Syndrome?

In children with Lennox-Gastaut syndrome (LGS), a rare and treatment-resistant form of epilepsy, questionnaires and wearable technology are feasible and parent-preferred methods of long-term sleep assessment, according to study results presented at the 2025 Annual Meeting of the American Academy of Sleep Medicine and the Sleep Research Society, held from June 7 to 11 in Seattle, Washington.

Despite the high burden of sleep disturbances for children with LGS, there is a lack of research on systematic assessment tools tailored for their long-term sleep assessment needs.

In a prospective feasibility pilot study, researchers evaluated various ambulatory sleep monitoring modalities in children with LGS with the goal of identifying methods that are practical and acceptable for long-term use.

A total of 15 participants were enrolled and invited to complete multiple forms of sleep assessment over a 4-week period. These included a single-night polysomnogram, a home sleep apnea test (WatchPAT), continuous Apple Watch use, and daily sleep logs. Caregivers also completed the Pediatric Sleep Questionnaire at baseline and study conclusion. At the end of participation, caregivers rated each modality across several domains including convenience, ease of use, comfort, and perceived accuracy. They used a 5-point Likert scale, and selected their preferred method.

The children had a mean age of 12.2 years, and 58% were girls. Participants wore the Apple Watch for an average of 13.8 days and remained in the study for an average of 16.9 days.

The researchers found that questionnaires and the Apple Watch were rated most convenient, with mean scores of 4.1 and 3.7, respectively. In contrast, the WatchPAT and polysomnogram were rated least convenient (both 2.4). When asked to identify the most preferred modality overall, caregivers ranked the Apple Watch highest (mean rank 1.6), followed by the WatchPAT (3.3) and then the polysomnogram (4.1).

Sleep apnea testing using both WatchPAT and polysomnography yielded similar results in 2 of 3 cases, though 1 showed divergent indices. While full validation remains necessary, the findings suggest that WatchPAT may offer a less burdensome alternative in select cases.

Study limitations included the small sample size, potential selection bias among participating families, and limited validation data comparing wearable devices to gold-standard polysomnography.

“WatchPATs might be a feasible alternative to a polysomnogram in appropriate scenarios,” the researchers concluded.

This research was supported by the Lennox-Gastaut Syndrome Foundation.