Abstract
Background: Obstructive sleep apnea (OSA) is a source of significant morbidity in children. Polysomnography (PSG), the gold standard diagnostic tool for OSA, is often unavailable due to patient financial and geographic constraints. Our objective is to analyze the relationship between a patient's subjective complaints and the results from their PSG to determine the diagnostic value of the Pediatric Sleep Questionnaire (PSQ) for detecting OSA in children.Methods: A retrospective chart review was conducted for pediatric patients with suspected OSA from March 2012 to January 2014. Preoperative PSQ scores were compared with the results from PSG in the form of Apnea-Hypopnea Index (AHI) and Respiratory Disturbance Index (RDI) values. AHI and RDI values ranging from 1 to 5 were classified as mild OSA while values ranging from 5 to 10 were classified as moderate OSA.Results: A total of 161 patients were recruited for this study with 63 patients (39%) both completing the PSQ and undergoing PSG. Sensitivity of the positive questionnaire was higher in patients with AHI and RDI values indicative of moderate OSA (95% and 100% respectively) versus values indicative of mild OSA (83% and 86% respectively). Conversely, the positive predictive value of the positive questionnaire (n=49) was lower in patients with AHI and RDI values indicative of moderate OSA (39% and 46% respectively) versus values indicative of mild OSA (70% and 80% respectively).Conclusion: The PSQ has high diagnostic value for screening patients with suspected OSA. We recommend the use of the PSQ in the primary care setting for children with suspected OSA.
Highlights
Obstructive sleep apnea (OSA) affects between 1.2% to 5.7% of children and adolescents in the United States and is associated with significant morbidity [1]
We observed a mild correlation between Respiratory Disturbance Index (RDI) values greater than 5 and positive questionnaire scores (κ = 0.18)
In this retrospective study we investigated the efficacy of the Pediatric Sleep Questionnaire (PSQ) developed by Chervin et al for the diagnosis of OSA in the pediatric population [11]
Summary
Obstructive sleep apnea (OSA) affects between 1.2% to 5.7% of children and adolescents in the United States and is associated with significant morbidity [1]. OSA is characterized by episodic upper airway collapse with concomitant apnea or hypopnea throughout sleep [2,3]. Pediatric patients with OSA are at an increased risk for the development of cardiovascular complications secondary to chronic hypertension [7]. Obstructive sleep apnea (OSA) is a source of significant morbidity in children. Our objective is to analyze the relationship between a patient's subjective complaints and the results from their PSG to determine the diagnostic value of the Pediatric Sleep Questionnaire (PSQ) for detecting OSA in children
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