Related Experiment Video
Updated: Aug 16, 2025
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Utility of Screening for Obstructive Sleep Apnea with the Pediatric Sleep Questionnaire (PSQ) in Children with
Roberto N Solis1, Sukhkaran S Aulakh1, Oscar S Velazquez-Castro1
1Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California, USA.
Insights
The Pediatric Sleep Questionnaire (PSQ) is not accurate for screening obstructive sleep apnea (OSA) in children with craniofacial anomalies. A specialized tool is needed due to low sensitivity and specificity, especially in syndromic cases.
Area of Science:
- Pediatric pulmonology
- Sleep medicine
- Craniofacial medicine
Background:
- Obstructive sleep apnea (OSA) is common in children with craniofacial anomalies.
- Accurate screening tools are crucial for timely diagnosis and intervention.
Purpose of the Study:
- To evaluate the accuracy of the Pediatric Sleep Questionnaire (PSQ) as a screening tool for OSA in children with craniofacial anomalies.
- To assess the sensitivity and specificity of the PSQ in this specific pediatric population.
Main Methods:
- Retrospective cohort study involving children aged 2-18 with craniofacial anomalies.
- Comparison of PSQ screening results with polysomnography (PSG) data.
- Analysis of sensitivity and specificity for detecting an obstructive apnea-hypopnea index (AHI) ≥ 5 events/hour.
Main Results:
- The PSQ showed lower sensitivity (70%) and specificity (40%) for detecting OSA in children with craniofacial anomalies compared to the general population.
- Accuracy was particularly diminished in children with syndromic or chromosomal anomalies (sensitivity 65%, specificity 31%).
- No correlation was found between PSQ score and OSA severity (p=0.25).
Conclusions:
- The PSQ is not a reliable screening tool for OSA in children with craniofacial anomalies, especially those with syndromes.
- There is a need for a validated, craniofacial-specific screening tool to improve OSA detection in this vulnerable group.
Objective:
To determine the accuracy of the Pediatric Sleep Questionnaire (PSQ) as a screening tool for obstructive sleep apnea in children with craniofacial anomalies.
Design:
Retrospective cohort study.
Setting:
Multidisciplinary cleft and craniofacial clinic at a tertiary care center.
Patients:
Children with craniofacial anomalies 2 to ≤18 years of age who both completed a PSQ screen and underwent polysomnography (PSG) without interval surgery.
Main Outcome Measures:
Sensitivity and specificity of the PSQ in detecting an obstructive apnea-hypopnea index (AHI) ≥ 5 events/hour.
Results:
Fifty children met study criteria, with 66% (n = 33) having an associated syndrome. Mean patient age at time of PSQ was 9.6 + 4.0 years. Overall, 33 (64%) screened positive on the PSQ, while 20 (40%) had an AHI ≥ 5. The sensitivity and specificity for identifying AHI ≥ 5 was 70% and 40%, respectively. With subgroup analysis, the sensitivity and specificity were higher (100% and 50%) in children with non-syndromic palatal clefting but lower (65% and 31%) in children with a syndrome or chromosomal anomaly. There was no correlation detected between PSQ score and AHI severity (p = 0.25). The mean obstructive AHI in the study population was 10.1 ± 22.7 despite 44% (n = 22) undergoing prior adenotonsillectomy.
Conclusions:
The PSQ was less sensitive and specific in detecting an AHI ≥ 5 in children with craniofacial anomalies than in a general population, and particularly poor in for children with syndrome-associated craniofacial conditions. Given the high prevalence of OSA in this patient population, a craniofacial-specific validated screening tool would be beneficial.
Related Concept Videos
01:21Sleep Apnea
The condition is more prevalent among...
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
01:28Physical Assessment of the Respiratory Tract I: Health History
Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and...