Validation of a questionnaire instrument for prediction of obstructive sleep apnea in Hong Kong Chinese children

Li, Albert M.; Cheung, Asy; Chan, Daniel; Wong, Eric; Ho, Crover Kwok Wah; Lau, Joseph T. F.; Wing, Yun Kwok

doi:10.1002/ppul.20505

Cited by 94 publications

(67 citation statements)

References 29 publications

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“…1 A set of questions is likely to provide a better and more reliable approach if one wants to screen across a spectrum of SDB, and attempts to fi nd such a set are encountered in the literature. 1,[34][35][36][37][38][39] Despite their differences, those results are comparable to those presented here, which in addition were generated in a large community sample, and indicate that a set of ordered questions or the severity hierarchy of complaints is reliable for screening purposes. More specifi cally, a criterion of .…”

Section: Discussionsupporting

confidence: 73%

Screening of Pediatric Sleep-Disordered Breathing

Spruyt

Gozal

2012

Chest

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Sleep-disordered breathing (SDB) is a frequent condition in children. In the last 2 decades, associations between SDB and behavioral, neurocognitive, cardiovascular, and metabolic morbidities have been extensively reported, and dose-dependent relationships with certain polysomnographic measures and even sleep-related questions have been suggested. [1][2][3][4][5][6] However, the eventual impact of SDB on impairments in the quality of life of a developing child 7,8 may be best understood in the context of a spectrum of disease, rather than specifi c clinical categories (eg, mild, moderate, severe). Although the primary symptom of SDB is habitual snoring, which is indicative of the presence of increased upper airway resistance during sleep, the actual perception as to the presence of snoring and associated symptoms is highly subjective. [9][10][11][12] Complaints of snoring and somnolence, 13 diminished performance, behavioral problems, 14 or headaches 15 by nonapneic snorers will not reliably discriminate them from those with habitual snoring who suffer Background: Identifi cation of sleep-disordered breathing (SDB) using questionnaires is critical from a clinical and research perspective. However, which questions to use and how well such questionnaires perform has thus far been fraught with substantial uncertainty. We aimed at delineating the usefulness of a set of questions for identifying pediatric SDB. Methods: Random prospective sampling of urban 5-to 9-year-old children from the community and enriched for habitual snoring underwent overnight sleep study. Subjective indicators or questions were evaluated to further characterize and discriminate SDB. Results: Of 1,133 subjects, 52.8% were habitual snorers. This sample was analyzed based on a clinical grouping (ie, established apnea-hypopnea index cutoffs). Several statistical steps were performed and indicated that complaints can be ranked according to a severity hierarchy: shake child to breathe, apnea during sleep, struggle breathing when asleep, and breathing concerns while asleep, followed by loudness of snoring and snoring while asleep. With a posteriori cutoff, a predictive score . 2.72 on the severity scale was found (ie, area under the curve, 0.79 Ϯ 0.03; sensitivity, 59.03%; specifi city, 82.85%; positive predictive value, 35.4; negative predictive value, 92.7), making this cutoff applicable for confi rmatory purposes. Conclusions: As a result, the set of six hierarchically arranged questions will aid the screening of children at high risk for SDB but cannot be used as the sole diagnostic approach.CHEST 2012; 142(6):1508-1515

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Section: Discussionsupporting

confidence: 73%

Screening of Pediatric Sleep-Disordered Breathing

Spruyt

Gozal

2012

Chest

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“…Nonetheless, selfreported measures have been shown to offer sufficient validity in studying sleep habits in adolescents in large-scale population studies. 31,39,45 In fact, our previous study found considerable correlations between sleep questionnaire and actigraphy findings in sleep pattern and duration. 11 Second, we only measured students' sleep and behavioral change at a 5-week follow-up due to limited resources.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…The General Sleep Questionnaire (HKCSQ) is a comprehensive and validated questionnaire used to measure various sleep issues such as insomnia symptoms and sleep-wake patterns during school days and weekends, with an adaptation to measure the sleep variables over the last month. 31,32 The insomnia symptoms were measured according to frequency and were defined as abnormal if they occurred $3 times per week. Sleep duration was…”

Section: Measurementsmentioning

confidence: 99%

A School-Based Sleep Education Program for Adolescents: A Cluster Randomized Trial

Wing¹,

Chan²,

Yu³

et al. 2015

PEDIATRICS

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To evaluate the effectiveness of a multilevel and multimodal school-based education program.METHODS: A cluster randomized controlled trial with 14 secondary schools in Hong Kong and a total of 3713 students (intervention: 1545 vs control: 2168; 40.2% boys; mean age 6 SD: 14.72 6 1.53 years) were included in the final analysis. The intervention included a town hall seminar, small class workshops, a slogan competition, a brochure, and an educational Web site. Their parents and teachers were offered sleep education seminars. The control schools did not receive any sleep program. Data were collected before and 5 weeks after the intervention.

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“…Patients were excluded from the study if they were active smokers (self-reporting and confirmed by parents), had an intercurrent upper respiratory tract or systemic infection within 4 weeks of recruitment, suffered from neuromuscular disorder such as Duchenne muscular dystrophy, craniofacial anomalies, syndromic disorder for example Down syndrome, or if they had previously undergone upper airway surgery. Each subject and their parent completed a sleep-disordered breathing questionnaire 23 that inquired about nighttime and daytime symptoms of OSA and past personal medical history. The study was approved by the Clinical Research Ethics Committee of the Chinese University of Hong Kong.…”

Section: Subjectsmentioning

confidence: 99%

C‐reactive protein in children with obstructive sleep apnea and the effects of treatment

Chan

Yin

et al. 2007

Pediatric Pulmonology

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Summary. Objective To evaluate C-reactive protein (CRP) concentration in children with OSA and to determine the effects of treatment for OSA on its serum concentration. Methods Consecutive children with habitual snoring and symptoms suggestive of OSA were recruited. They completed a sleep apnea symptom questionnaire, underwent physical examination and an overnight polysomnography (PSG). Fasting serum CRP and lipid profile were taken after overnight PSG. OSA was diagnosed if obstructive apnea index (OAI) > 1. Results One hundred forty-one children with a median (IQR) age of 10.8 (8.5-12.8) years were recruited. There were 96 boys and the commonest presenting symptoms were nocturnal mouth breathing, prone sleeping position and poor attention at school. Forty-five children were found to have OSA and those with moderate disease (OAI > 5) had significantly higher CRP levels compared to their non-OSA counterparts

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Validation of a questionnaire instrument for prediction of obstructive sleep apnea in Hong Kong Chinese children

Cited by 94 publications

References 29 publications

Screening of Pediatric Sleep-Disordered Breathing

Screening of Pediatric Sleep-Disordered Breathing

A School-Based Sleep Education Program for Adolescents: A Cluster Randomized Trial

C‐reactive protein in children with obstructive sleep apnea and the effects of treatment

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