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Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring,
Insights
This study developed and validated the Pediatric Sleep Questionnaire to accurately identify childhood sleep-related breathing disorders (SRBDs), snoring, and sleepiness in children, offering a reliable alternative to polysomnography for research.
Area of Science:
- Pediatric Sleep Medicine
- Respiratory Disorders
- Behavioral Science
Background:
- Childhood sleep-related breathing disorders (SRBDs) are prevalent yet frequently undiagnosed.
- Polysomnography, while definitive, is expensive and not always feasible for large-scale research.
- Developing cost-effective screening tools is crucial for advancing clinical and epidemiological studies on pediatric SRBDs.
Purpose of the Study:
- To create and validate questionnaire scales for identifying childhood SRBDs and associated symptoms.
- To assess the reliability and validity of these scales in a pediatric population.
- To provide research tools for investigating snoring, daytime sleepiness, and behavioral disturbances linked to SRBDs.
Main Methods:
- Development and validation of a Pediatric Sleep Questionnaire.
- Item reduction and scale creation using data from children aged 2-18 years.
- Logistic regression analysis to assess scale association with polysomnographically confirmed SRBDs.
Main Results:
- A 22-item SRBD score demonstrated strong association with SRBD diagnosis (P<0.0001).
- Subscores for snoring, sleepiness, and behavior also showed significant correlations with SRBD diagnosis.
- The scales exhibited high sensitivity (0.81-0.85), specificity (0.87), and correct classification (85-86%), with good internal consistency and test-retest stability.
Conclusions:
- The developed scales are valid and reliable instruments for childhood SRBDs, snoring, sleepiness, and behavior.
- These scales can effectively identify SRBDs and related symptom complexes in clinical research settings.
- The questionnaire offers a feasible alternative to polysomnography for identifying pediatric sleep disorders.
Abstract:
Objective: To develop and validate questionnaire scales that can be used in research to investigate the presence of childhood SRBDs and prominent symptom complexes, including snoring, daytime sleepiness, and related behavioral disturbances.Background: Obstructive sleep-related breathing disorders (SRBDs) are common but usually undiagnosed among children. Methods to help identify SRBDs without the expense of polysomnography could greatly facilitate clinical and epidemiological research.Methods: Subjects were children aged 2-18 years who had polysomnographically-confirmed SRBDs (n=54) or appointments at either of two general pediatrics clinics (n=108). Parents completed a Pediatric Sleep Questionnaire which contained items under consideration for inclusion in desired scales.Results: Item reduction, based on data from a randomly selected 50% of the subjects (group A), produced a 22-item SRBD score that was strongly associated with diagnosis of an SRBD (P<0.0001) in a logistic regression model that accounted for age and gender. Diagnosis was also strongly associated with subscores for snoring (four items, P<0.0001), sleepiness (four items, P=0.0003), and behavior (six items, P<0.0001) among group A subjects. The scales performed similarly well among group B subjects, and among subjects of different ages and gender. In group A and B subjects, respectively, a selected criterion SRBD score produced a sensitivity of 0.85 and 0.81; a specificity of 0.87 and 0.87; and a correct classification for 86 and 85% of subjects. The scales showed good internal consistency and, in a separate sample (n=21), good test-retest stability.Conclusions: These scales for childhood SRBDs, snoring, sleepiness, and behavior are valid and reliable instruments that can be used to identify SRBDs or associated symptom-constructs in clinical research when polysomnography is not feasible.