Limitations of the apnea-hypopnea index in children and young adults with neuromuscular disorders

•There are no validated parameters for noninvasive ventilation initiation in children with neuromuscular disease.•Apnea-hypopnea indexes of 5 or 10 events/hour have been proposed to initiate noninvasive ventilation.•Patients with neuromuscular disease may have abnormal nocturnal gas exchange with a normal apnea-hypopnea index.•Overnight gas exchange abnormalities are important for noninvasive ventilation initiation.