Abstract
PurposeObstructive sleep apnea (OSA) is prevalent in children and diagnostic polysomnography is costly and not readily available in all areas. We developed a pediatric modification of a commonly used adult clinical prediction tool for stratifying the risk of OSA and the need for polysomnography.MethodsA total of 312 children (age 9–17 years) from phase 2 of the Tucson Children’s Assessment of Sleep Apnea cohort study, with complete anthropomorphic data, parent questionnaires, and home polysomnograms were included. An adolescent modification of STOP-Bang (teen STOP-Bang) was developed and included snoring, tired, observed apnea, blood pressure ≥ 95th percentile, BMI > 95th percentile, academic problems, neck circumference >95th percentile for age, and male gender. An apnea-hypopnea index ≥ 1.5 events/hour was considered diagnostic of OSA.ResultsReceiver Operator Characteristic (ROC) curves for parent-reported STOP-Bang scores were generated for teenage and pre-teen children. A STOP-Bang score of < 3 in teenagers was associated with a negative predictive value of 0.96. ROC curves were also generated based upon child-reported sexual maturity rating (SMR; n = 291). The ability of teen STOP-Bang to discriminate the presence or absence of OSA as measured by the AUC for children with SMR ≥ 4 (0.83; 95%CI 0.71–0.95) was better than children with SMR < 4 (0.63; 95%CI 0.46–0.81; p = 0.048).ConclusionsIn community dwelling adolescents, teen STOP-Bang may be useful in stratifying the risk of OSA.
Highlights
In children and adolescents, obstructive sleep apnea (OSA) has a prevalence of 1.2–5.7% [1] and has been associated with behavioral, neurocognitive, learning and cardiovascular problems [2]
Teen STOP-Bang may be useful in stratifying the risk of OSA
We hypothesized that a modified version of the STOP-Bang tool may be useful as a clinical prediction tool to determine the need for polysomnography in children, adolescents, who may have a more adult-like phenotype of OSA
Summary
Obstructive sleep apnea (OSA) has a prevalence of 1.2–5.7% [1] and has been associated with behavioral, neurocognitive, learning and cardiovascular problems [2]. We hypothesized that a modified version of the STOP-Bang tool may be useful as a clinical prediction tool to determine the need for polysomnography in children, adolescents, who may have a more adult-like phenotype of OSA. The following were included as the teen STOP-Bang tool: Snoring (How often does your child snore loudly?), Tired (Is your child sleepy during the daytime?), Observed apnea (Does your child stop breathing during sleep?), systolic or diastolic blood pressure greater than or equal to 95th percentile for height and age, BMI greater than 95th percentile for age, Academic problems (Does your child have learning problems?), Neck circumference greater than 95th percentile for age, and male Gender.
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