Abstract: Introduction: OSA children gold standar diagnosis method is polysomnography (PSG), wich is expensive and not available across centers. HRP has been proposed as diagnostic method but its validity evidence is still scarce. Objetive was to assess the diagnostic validity of HRP compared with the PSG. Material and Methods: Randomized, single blind and crossover trial in children aged 2 to 14 years with clinical suspicion of OSA. They performed HRP (Apnea link Air®) and PSG were carried out in different order according to randomization. Data from HRP and from full PSG will be compared according to the different apnea-hypopnea index (AHI) and the concordance of the diagnosis when using clinical findings and data from PSG or HRP. Results: 493 children were randomized; 248 began with HRP continuing with PSG (group I) and 245 started with PSG followed by a HRP (Group II). It was necessary to repeat 4 of 208 PSG (1,9%) and 90 of 211 HRP (42,7%) in group I, being valid after repetition 3 of 4 PSG (75%) and 31 of 90 HRP (34%). In group II, 7 of 201 PSG (3%) and 89 of 215 HRP (41%) were repeated, being valid after repetition 5 of 7 PSG (71%) and 43 of 89 HRP (48%).Difference was found between PSG AHI (3.9;IR 2.3?7.3) and HRP AHI (3.3;IR 1.8?5.7), p=0.001.Correlation between both AHI values was 0.455 (p<0.001) and intraclass correlation coefficient was 0.491(0.277-0.632). Area under AHI HRP curve of the diagnosis of OSA with AHI PSG higher than 3, was 0.753 (0,694-0,811). Conclusion: Results of validity of this HRP is only modest and not allow a generalized use for diagnosis of OSA in children. It forces to repeat almost half of test, and then only half of these are valid.

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