Is the OSA-18 predictive of obstructive sleep apnea: comparison to polysomnography

Area of Science:

• Pediatric Sleep Medicine
• Respiratory Medicine
• Clinical Diagnostics

Background:

• Obstructive Sleep Apnea (OSA) is a common condition in children.
• Accurate diagnosis of OSA is crucial for effective management.
• The OSA-18 questionnaire is a tool used to assess OSA symptoms in children.

Purpose of the Study:

• To evaluate the diagnostic accuracy of the OSA-18 questionnaire in predicting OSA.
• To compare the OSA-18's performance against polysomnography (PSG), the gold standard diagnostic test.
• To assess the OSA-18's predictive ability in a racially diverse pediatric population.

Main Methods:

• A cross-sectional retrospective study design was employed.
• Data from 79 children (ages 2-12) with diagnosed OSA were analyzed.
• Logistic regression was used to assess the association between OSA-18 total symptom score (TSS) and OSA, controlling for demographic and clinical factors.

Main Results:

• The OSA-18 demonstrated a positive predictive value (PPV) greater than 90% for an obstructive apnea-hypopnea index (oAHI) ≥ 1.
• However, sensitivity and negative predictive value (NPV) of the OSA-18 TSS were low across all severity levels of OSA and for both white and nonwhite children.
• Age, race, and BMI were not significantly associated with oAHI.

Conclusions:

• The OSA-18 questionnaire exhibits low sensitivity and NPV, making it unreliable for diagnosing OSA in children.
• The tool is insufficient for detecting OSA or confirming its absence, even in a diverse cohort.
• The OSA-18 is best utilized as a quality-of-life indicator rather than a substitute for polysomnography.