The McGill score as a screening test for obstructive sleep disordered breathing in children with co-morbidities

Abstract

Please cite this article as: Trucco F, Rosenthal M, Bush A, Tan H-L, The McGill score as a screening test for obstructive sleep disordered breathing in children with co-morbidities, Sleep Medicine,

Use of oximetry to screen for paediatric obstructive sleep apnoea: is one night enough and is 6 hours too much?

“…Interestingly, a recent study suggests that the positive predictive value of the MOS may be lower in this group due to non-obstructive conditions causing desaturations. [20] The lower time threshold required to score nocturnal pulse oximetry tracings has been taken as 6 hours. [4] It has been recognised that further work needs to be done to determine the minimum recorded sleep time for children.…”

Alternatives to surgery in children with mild OSA

“…Since then, professional associations such as the American Academy of Pediatrics, American Academy of Sleep Medicine, American Academy of Otolaryngology-Head and Neck Surgery Foundation, European Respiratory Society, have further suggested that in the presence of characteristic OSA symptoms and some supportive physical findings, implementation of simplified testing procedures could replace the gold standard PSG in the form of home-based multichannel respiratory recordings or even single channel overnight oximetry. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 We have been among the latter, particularly based on the concern of limited access to PSG testing for children along with excessive financial costs. Development of such validated scalable diagnostic tools that can be automated would substantially reduce financial burden as well as time consuming labor involved in scoring and interpretation of polysomnograms.…”

“…Development of such validated scalable diagnostic tools that can be automated would substantially reduce financial burden as well as time consuming labor involved in scoring and interpretation of polysomnograms. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 Such approaches if adopted more universally, would result not only in expedited evaluation of many children who currently are required to wait for long periods of time before being diagnosed, but would also facilitate access to pediatric sleep laboratories for those children in whom the diagnosis is uncertain, or the clinical presentation is more complex and requires more sophisticated diagnostic approaches.…”

“…Not so long ago, many of our clinical colleagues endorsed an approach that stipulated that every child who is symptomatic, e.g., habitually snores during sleep, should undergo adenotonsillectomy (AT), without requiring any diagnostic test such as a PSG. Since then, professional associations such as the American Academy of Pediatrics, American Academy of Sleep Medicine, American Academy of Otolaryngology‐Head and Neck Surgery Foundation, European Respiratory Society, have further suggested that in the presence of characteristic OSA symptoms and some supportive physical findings, implementation of simplified testing procedures could replace the gold standard PSG in the form of home‐based multichannel respiratory recordings or even single channel overnight oximetry 6–34 . We have been among the latter, particularly based on the concern of limited access to PSG testing for children along with excessive financial costs.…”

Topic Sessions

“…The McGill score is used worldwide as a screening tool to predict the presence and classify the severity of obstructive sleep apnea syndrome (OSAS) in children. Trucco et al (1) compared the McGill score to the results of cardiorespiratory polygraphy in 312 children, including 183 with an associated medical condition. Their results confirm previous data showing that the positive predictive value of the McGill score for OSAS is lower in children with an associated medical condition.…”