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Published on: February 14, 2019
Sleep disordered breathing in children - Diagnostic questionnaires, comparative analysis
Marcin Burghard1, Eliza Brożek-Mądry2, Antoni Krzeski2
1Medical Center in Ostrołęka, Branch in Różan, Poland.
Insights
Screening for childhood obstructive sleep disordered breathing (SDB) can be done using several questionnaires when polysomnography is unavailable. While some tools are simple and quick, further research is needed to improve their specificity for accurate diagnosis.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Diagnostic Tools
Background:
- Obstructive sleep disordered breathing (SDB) in children requires effective screening methods.
- Polysomnography (PSG) is the gold standard but often unavailable in clinical practice.
- Questionnaires can aid in early detection and management of pediatric SDB.
Purpose of the Study:
- To present and analyze available questionnaires for screening childhood obstructive SDB.
- To evaluate questionnaires for diagnostic utility when PSG is not feasible.
- To guide selection of appropriate screening tools in clinical settings.
Main Methods:
- Comparative analysis of seven pediatric SDB screening questionnaires.
- Evaluation criteria included administration simplicity, time, personnel requirements, symptom scope, sensitivity, and specificity.
- Questionnaires analyzed: Pediatric Sleep Questionnaire (PSQ), Sleep Clinical Record (SCR), OSA-18, Brouilette score (BS), I'M SLEEPY, and SSSDR.
Main Results:
- Six of seven questionnaires were simple to administer, taking 1-60 minutes.
- Physical examination was required for two questionnaires; physician involvement for three.
- Sensitivity ranged from 59-96%, while specificity ranged from 46-72%.
Conclusions:
- Several questionnaires offer quick, inexpensive screening for obstructive SDB in children.
- Four questionnaires show potential utility in diagnosing pediatric SDB.
- Further optimization, particularly enhancing specificity, is needed for these screening tools.
Study Objectives:
The purpose of this work is to present available questionnaires enabling diagnostic screening when obstructive sleep disordered breathing (SDB) in a child is suspected or its effects are observed and polysomnography is unavailable. These questionnaires are designed to facilitate further diagnostic process or even therapeutic decisions, aid in selecting the optimal one for the specified conditions of clinical practice, with the caveat that none of these represents a diagnostic equivalent to PSG.
Methods:
The questionnaires subjected to analysis: Pediatric Sleep Questionnaire (PSQ), Sleep Clinical Record (SCR), OSA-18 score (OSA-18), Brouilette score (BS), "I'm Sleepy" questionnaire (I'M SLEEPY), and "Sleeping Sleepless Sleepy Disturbed Rest" questionnaire (SSSDR). The comparative analysis of questionnaires included the following parameters: simplicity and time of administer; necessity to engage a physician or other trained individual; taking into account examination of the patient; type and scope of considered symptoms and consequences of obstructive SDB, sensitivity, specificity, recommendations of the guidelines.
Results:
Seven questionnaires were subjected to analysis with presentation of their similarities and differences. Six out of seven were evaluated as simple in administration. Time required to fulfill the questionnaires ranged between 1 and 60 min. Three of them involved a physician or a trained personnel. Physical examination was necessary in two out of seven questionnaires. Sensitivity was estimated in 5 of them and ranged between 59 and 96%. Specificity ranged between 46 and 72%.
Conclusions:
Several questionnaires enabling quick, simple, and inexpensive screening for OSAS have been created. Four (of the seven analyzed) questionnaires may be useful in diagnosis of obstructive SDB in children - two follow current (2015) recommendations. However, there is a need for further work on optimizing such tools, particularly on improving their specificity.
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