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Introduction Prevalence of children with complex neurodisability, for whom diagnostic pathways are not well defined for sleep disordered breathing (SDB), is rising and comprises a significant proportion of referrals to paediatric sleep diagnostic services. This study assessed:Indications and outcomes of cardiorespiratory polygraphy studies (CRSS) conducted for children with neurodisability, referred to a tertiary paediatric sleep service for screening for SDB.Whether the less resource-intensive ‘oxy-capnography’ (O2CO2) is a sufficient screening tool for SDB in the above cohort.Methods Retrospective analysis was undertaken of clinical details, diagnostic CRSS parameters and outcomes of children with neurodisability referred for CRSS from January 2023 to May 2025.Study outcomes were categorised into 4 classifications (figure 2). Suitability of using Oxygen Desaturation Index (ODI) as a surrogate for Apnoea-Hypopnoea Index (AHI) was calculated with ROC curve analysis using the Wilson/Brown method. Correlations between CRSS parameters were analysed using Spearman Rank correlation analysis (GraphPad Prism v.10, Boston, USA).Results Forty-eight patients were included. Median age 8 (IQR 5-11). The majority of patients (52%) had gene mutation associated neurodisability and 29% had cerebral palsy ( figure 1). 18.8% of patients were identified as abnormal requiring intervention (figure 2); 8.3% were recommended for ENT intervention and 10.4% were initiated on oxygen therapy.The AUC value for ODI as a diagnostic index for moderate or higher severity SDB was 0.91 (95% CI 0.86-0.97). Sensitivity was 0.82 and specificity was 0.90 for using ODI >5/hr as the diagnostic cut-off. There was a significant positive correlation between AHI and ODI, r=0.96, p=<0.001.Conclusion Only a minority of patients with neurodisability were diagnosed with an abnormal sleep study needing intervention. The strong correlation between AHI and ODI in this cohort indicates the outcomes would have likely been the same if only data & visual trends from O2CO2 studies were analysed.Abstract P40 Figure 1Patient diagnosesAbstract P40 Figure 2CRSS outcomes