Can the Sleep Clinical Record diagnose moderate-to-severe Obstructive Sleep Apnea Syndrome in children?

Abstract

<b>Objective:</b> The Sleep Clinical Record (SCR)¹ has been used for the diagnosis of mild obstructive sleep apnea syndrome (OSAS) in children when access to polysomnography (PSG) is limited. We aimed to determine the cut-off value of the SCR that would be useful for the diagnosis of moderate-to-severe OSAS (obstructive AHI &gt;5/h) in children with snoring. <b>Methods:</b> Otherwise, healthy children with snoring and adenotonsillar hypertrophy and/or obesity who were referred for PSG were recruited prospectively, and SCR score was calculated. Receiver operating characteristic curves (ROC) were plotted to determine the Area Under Curve (AUC) and the optimal SCR cut-off value was calculated using the Youden index (J). <b>Results:</b> 273 children were recruited (mean age 6.3 ± 2.53 years; median obstructive AHI 2.93 episodes/h range 0–61.1). Mean SCR score was 6.89 ± 3.59. Forty-six children had moderate-to-severe OSAS. Children with moderate-to-severe OSAS had significantly greater mean score in SCR (10.23 ± 2.86) than those with mild OSAS (6.20 ± 3.34; P&lt; 0.001). Based on the plotted ROC, the AUC was determined to be 0.811 (95% Confidence Interval: 0.747 - 0.876; P&lt;0.001). Calculation of J, based on its ROC coordinates indicated that optimal cut-off SCS score was 8.25, corresponding to a Sensitivity of 82.6 % and a Specificity of 70.5%. <b>Conclusion:</b> SCR score &gt;8.25 can identify children with moderate-to-severe OSAS among those with snoring. <b>Sleep clinical record:</b> an aid to rapid and accurate diagnosis of paediatric sleep disordered breathing. Villa MP, Paolino MC, Castaldo R, Vanacore N, Rizzoli A, Miano S, Del Pozzo M, Montesano M. Eur Respir J. 2013 Jun;41(6):1355-61.