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Medline ® Abstract for Reference 98

of 'Evaluation of suspected obstructive sleep apnea in children'

98
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Pediatric sleep questionnaire: prediction of sleep apnea and outcomes.
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Chervin RD, Weatherly RA, Garetz SL, Ruzicka DL, Giordani BJ, Hodges EK, Dillon JE, Guire KE
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Arch Otolaryngol Head Neck Surg. 2007;133(3):216.
 
OBJECTIVES: To further validate a questionnaire about symptoms of childhood obstructive sleep apnea (OSA) and to compare the questionnaire with polysomnography in their ability to predict outcomes of adenotonsillectomy.
DESIGN: Retrospective analysis of data from a longitudinal study.
SETTING: University-based sleep disorders laboratory.
PARTICIPANTS: The Washtenaw County Adenotonsillectomy Cohort, comprising 105 children aged 5.0 to 12.9 years at entry. Intervention Parents completed the 22-item Sleep-Related Breathing Disorder (SRBD) scale of the Pediatric Sleep Questionnaire, and children underwent polysomnography before and 1 year after clinically indicated adenotonsillectomy (n = 78, usually for suspected OSA) or unrelated surgical care (n = 27).
MAIN OUTCOME MEASURES: Findings from commonlyused hyperactivity ratings, attention tests, and sleepiness tests.
RESULTS: At baseline, a high SRBD scale score (1 SD above the mean) predicted an approximately 3-fold increased risk of OSA on polysomnography (odds ratio, 2.80; 95% confidence interval, 1.68-4.68). One year later, OSA and symptoms had largely resolved, but a high SRBD score still predicted an approximately 2-fold increased risk of residual OSA on polysomnography (odds ratio, 1.89; 95% confidence interval, 1.13-3.18). Compared with several standard polysomnographic measures of OSA, the baseline SRBD scale better predicted initial hyperactivity ratings and 1-year improvement, similarly predicted sleepiness and its improvement, and similarly failed to predict attention deficit or its improvement.
CONCLUSIONS: The SRBD scale predicts polysomnographic results to an extent useful for research but not reliable enough for most individual patients. However, the SRBD scale may predict OSA-related neurobehavioral morbidity and its response to adenotonsillectomy as well or better than does polysomnography.
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Sleep Disorders Center, Department of Neurology, School of Public Health, University of Michigan, Ann Arbor, USA. chervin@umich.edu
PMID