Related Experiment Video
Updated: Aug 20, 2026
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
The validity of the OSA-18 among three groups of pediatric patients
Ali M Strocker1, Alexandra Carrer, Nina L Shapiro
1Department of Surgery, Division of Head and Neck Surgery, University of California Los Angeles Medical Center, USA.
Insights
Obstructive sleep apnea symptoms in pediatric transplant recipients and leukemia patients differ from healthy children. The OSA-18 questionnaire
Area of Science:
- Pediatric sleep medicine
- Transplant medicine
- Pediatric oncology
Background:
- Obstructive sleep apnea (OSA) is a concern in pediatric populations.
- Chronic illnesses may affect OSA symptoms and screening tool validity.
Purpose of the Study:
- Compare OSA signs and symptoms in solid organ transplant recipients, leukemia patients, and healthy children.
- Evaluate the obstructive sleep apnea-18-item questionnaire's (OSA-18) effectiveness in pediatric transplant recipients.
Main Methods:
- Cross-sectional study with 206 children (transplant recipients, leukemia patients, healthy controls).
- Adenotonsillar enlargement assessed via OSA-18 questionnaire and physical examination.
- Data collected during routine clinic visits.
Main Results:
- Significant differences in OSA-18 scores between healthy children and liver transplant recipients/leukemia patients.
- Leukemia patients showed significant differences in physical examination findings compared to other groups.
- Adenotonsillar enlargement prevalence did not differ significantly between transplant and healthy populations.
Conclusions:
- Adenotonsillar enlargement in pediatric transplant recipients may signal post-transplantation lymphoproliferative disorder.
- Chronic illness confounds OSA-18 scores in transplant recipients.
- Further research is needed to develop a reliable screening tool for transplant recipients at risk for adenotonsillar lymphoma.
Objective:
To compare the signs and symptoms of obstructive sleep apnea syndrome in three groups of pediatric patients; solid organ transplant recipients, healthy children, and children with leukemia; in order to examine the effects of chronic illness on the obstructive sleep apnea-18-item questionnaire and to investigate its validity as a screening tool for obstructive sleep apnea in the pediatric solid organ transplant population.
Methods:
In this cross-sectional study, there were two hundred and six subjects; 46 kidney transplant recipients, 59 liver transplant recipients, 34 patients with leukemia, and 67 healthy children. Adenotonsillar enlargement was assessed by using the obstructive sleep apnea-18-item questionnaire and by performing a focused physical examination of the oral and nasal cavity at the time of the child's routine visit in either the transplant clinic, outpatient oncology center, or general pediatric clinic.
Results:
Comparison of questionnaire scores amongst the three groups showed significant differences between the healthy children and liver transplant recipients as well as those with leukemia. There was a significant difference in the physical examination scores of the children with leukemia as compared to the other groups.
Conclusions:
Adenotonsillar enlargement in pediatric transplant recipients can be an early indication of post-transplantation lymphoproliferative disorder. However, the prevalence of adenotonsillar enlargement in the transplant population does not appear to differ from that of the healthy population. Additionally, scores on the OSA-18 in the transplant population were confounded by chronic illness. Further prospective studies need to be performed to develop a screening tool to identify transplant recipients at risk for post-transplantation adenotonsillar lymphoma.
