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Reliability of scoring arousals in normal children and children with obstructive sleep apnea syndrome

Tat Kong Wong1, Patricia Galster, Tai Shing Lau

  • 1Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong. wongtk@graduate.hku.hk

Sleep
|November 10, 2004
PubMed

Insights

Scoring shorter sleep arousals in children using modified criteria shows poor agreement between scorers. Standard American Sleep Disorders Association criteria ensure reliable arousal scoring in pediatric sleep studies.

Area of Science:

  • Pediatric Sleep Medicine
  • Respiratory Sleep Disorders

Background:

  • Arousal scoring in children typically follows American Sleep Disorders Association (ASDA) criteria, requiring a minimum 3-second duration.
  • Recent studies have explored shorter arousal durations (1-2 seconds) in pediatric populations, but their reliability is unverified.

Purpose of the Study:

  • To evaluate the interscorer reliability of scoring pediatric sleep arousals using standard ASDA 3-second criteria versus modified 1-second and 2-second criteria.
  • To determine if shorter arousal durations impact scoring consistency.

Main Methods:

  • Retrospective analysis of 36 pediatric polysomnograms (20 with obstructive sleep apnea, 16 normal controls).
  • Two experienced sleep practitioners independently scored arousals using ASDA 3-second criteria and modified 1-second and 2-second criteria.
  • Interscorer agreement was assessed using intraclass correlation coefficients (ICC).

Main Results:

  • Excellent interscorer agreement (ICC=0.90) was found for standard 3-second arousals.
  • Poor to fair interscorer agreement (ICC=0.35 for 1-second, ICC=0.42 for 2-second) was observed for modified shorter arousals.
  • Shorter arousals constituted less than 15% of the total scored arousals.

Conclusions:

  • Interscorer agreement for scoring pediatric sleep arousals is significantly poorer with modified criteria of 1-2 seconds compared to standard 3-second criteria.
  • The study recommends adherence to the standard ASDA 3-second criteria for consistent and reliable arousal scoring in children.
  • The findings suggest that shorter arousal durations do not reliably contribute to scoring consistency in pediatric sleep assessments.
Abstract

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