Efficacy of a Pediatric Sleep Questionnaire for the Diagnosis of Obstructive Sleep Apnea in Children

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.

Sleep‐related breathing disorders and cardiometabolic risk factors in pediatric kidney transplant recipients

“…to have a good sensitivity and specificity for identifying SRBDs in multiple studies when compared to polysomnography. 16,17 Furthermore, the use of a survey could have introduced recall bias…”

“…However, the PSQ has been demonstrated to be a valid and reliable tool for identifying SRBDs in clinical research settings when polysomnography is not feasible 15 . The PSQ has subsequently been shown to have a good sensitivity and specificity for identifying SRBDs in multiple studies when compared to polysomnography 16,17 . Furthermore, the use of a survey could have introduced recall bias into the sleep scores.…”

“…Meta‐analysis of 39 studied using the PSQ, showed that the questionnaire had a 74%, 82%, and 83% sensitivity for detecting pediatric mild, moderate, and severe OSA, respectively 16 . The Chervin PSQ was found to have a positive predictive value of 70% for AHI values indicating mild OSA 17 …”

“…A total of 54 subjects met inclusion criteria to participate in the study. The median age of participants was 13 (IQR 8.25,17). The median number of years post-transplant for participants was 2 (IQR = 1, 4).…”

“…16 The Chervin PSQ was found to have a positive predictive value of 70% for AHI values indicating mild OSA. 17…”