Obstructive sleep apnea screening in children with asthma.

Area of Science:

• Pediatric Pulmonology
• Sleep Medicine
• Asthma Research

Background:

• Obstructive sleep apnea (OSA) is prevalent in children with asthma, especially those who are obese.
• Current screening questionnaires for OSA in asthmatic children have limited accuracy.
• Identifying accurate screening methods for OSA in this vulnerable population is crucial.

Purpose of the Study:

• To identify specific questions from a sleep-related breathing disorder survey that are associated with OSA in children with asthma.
• To evaluate the diagnostic accuracy of individual survey questions and a composite score compared to body mass index (BMI) z-score for OSA screening.

Main Methods:

• A cohort of 136 children with asthma completed a sleep-related breathing disorder survey.
• Polysomnography was performed to diagnose OSA (apnea-hypopnea index ≥ 2 events/h).
• Logistic regression analyzed associations between survey questions and OSA; predictive values were calculated.

Main Results:

• The prevalence of OSA was 40% in the study sample.
• Loud snoring, morning dry mouth, and being overweight were significantly associated with OSA.
• The BMI z-score alone demonstrated higher positive (76.3%) and negative (72.2%) predictive values than the composite survey score (60.3% and 77.6%).

Conclusions:

• The body mass index z-score is a valuable and simple tool for screening obstructive sleep apnea in children with asthma.
• Routine application of BMI z-score screening is recommended due to its effectiveness and the potential impact of OSA on asthma morbidity.