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Utility of screening for obstructive sleep apnea syndrome in children with craniofacial disorders

Christopher M Cielo1, Jason Silvestre, J Thomas Paliga

  • 1Philadelphia, Pa. From the Divisions of Pulmonary Medicine and Plastic and Reconstructive Surgery, the Clinical and Translational Research Center, and the Sleep Center, The Children's Hospital of Philadelphia; and the Perelman School of Medicine at the University of Pennsylvania.

Plastic and Reconstructive Surgery
|August 28, 2014
PubMed

Insights

The Pediatric Sleep Questionnaire is not a reliable screening tool for obstructive sleep apnea syndrome in children with craniofacial disorders. Further research is needed to identify effective diagnostic methods for this high-risk population.

Area of Science:

  • Pediatric Sleep Medicine
  • Craniofacial Abnormalities
  • Sleep Disorders

Background:

  • Children with craniofacial disorders face a higher risk of obstructive sleep apnea syndrome (OSAS).
  • Current diagnostic methods for OSAS in this population are debated, with polysomnography being the gold standard but often impractical.
  • The effectiveness of the Pediatric Sleep Questionnaire (PSQ) for OSAS screening in children with craniofacial conditions is not well-established.

Purpose of the Study:

  • To evaluate the utility of the Pediatric Sleep Questionnaire (PSQ) as a screening tool for obstructive sleep apnea syndrome (OSAS) in children with craniofacial disorders.
  • To determine the sensitivity, specificity, and predictive values of the PSQ in this specific pediatric population.

Main Methods:

  • A retrospective review was conducted on 83 children (aged 2-18) with diagnosed craniofacial disorders.
  • Data collected included demographics, PSQ scores, and polysomnography (PSG) results.
  • Statistical analyses calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the PSQ for OSAS detection.

Main Results:

  • Of the 83 children, 53% screened positive on the PSQ, and 27.7% were diagnosed with OSAS via PSG.
  • The PSQ demonstrated low sensitivity (0.57) and specificity (0.48) for detecting OSAS in this cohort.
  • Positive and negative predictive values were 0.30 and 0.74, respectively, with a weak correlation between PSQ score and apnea-hypopnea index (r=0.152, p=0.17).

Conclusions:

  • A significant number of craniofacial patients referred for PSG have OSAS.
  • The Pediatric Sleep Questionnaire is an inadequate screening tool for OSAS in children with craniofacial conditions.
  • Further research is essential to identify appropriate patients with craniofacial disorders who require polysomnography or alternative OSAS evaluations.
Abstract

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