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Validation of the Dutch sleep-related breathing disorder scale from the pediatric sleep questionnaire: a diagnostic
Bibi E Becking1, Ronald E G Jonkman2, Dominique J P M Stumpel3
1Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. bbecking@me.com.
Insights
The Dutch Sleep-Related Breathing Disorder (SRBD) scale effectively screens for pediatric sleep-disordered breathing (PSDB). This validated tool aids primary care by identifying children needing further polysomnography (PSG) evaluation.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Diagnostic Accuracy Studies
Background:
- Pediatric sleep-disordered breathing (PSDB) is associated with significant comorbidities.
- Polysomnography (PSG) is the gold standard for PSDB diagnosis but has limited accessibility in primary care settings.
- Screening tools are needed to identify children who may benefit from PSG.
Purpose of the Study:
- To evaluate the validity of the Dutch version of the Pediatric Sleep Questionnaire (PSQ) Sleep-Related Breathing Disorder (SRBD) scale.
- To compare the SRBD scale's performance against PSG for diagnosing PSDB.
- To assess the SRBD scale's utility as a primary care screening tool.
Main Methods:
- A cross-sectional study involving 75 children undergoing PSG.
- Parents/caregivers completed the SRBD scale.
- Construct and criterion validity were assessed using PSG-confirmed PSDB and obstructive sleep apnea (OSA) diagnoses, with sensitivity, specificity, and AUC-ROC analyses.
Main Results:
- The SRBD scale scores significantly distinguished children with PSDB from controls.
- Sensitivity and specificity for OSA were 0.92 and 0.74, respectively.
- For PSDB (snoring and/or OSA), sensitivity and specificity were 0.85, with an AUC exceeding 0.87 for all PSG outcomes.
Conclusions:
- The Dutch SRBD scale demonstrates adequate screening performance for PSDB.
- It is a valid and useful tool for primary care physicians as an initial step in identifying children with potential PSDB.
- This facilitates earlier diagnosis and management of pediatric sleep disorders.
Purpose:
Pediatric sleep-disordered breathing (PSDB) is linked to various coexisting problems, and polysomnography (PSG) is the reference standard for diagnosis. However, limited access in primary care to PSG may hinder diagnosis. This study investigates the validity of the Dutch version of the Pediatric Sleep Questionnaire (PSQ) Sleep-Related Breathing Disorder (SRBD) scale as a screening tool for pediatric sleep-disordered breathing (PSDB), comparing its performance to PSG.
Methods:
In a cross-sectional study, 75 children underwent PSG while their parents or caregivers completed the SRBD scale. SRBD scores of 34 children with PSG-confirmed PSDB were compared to those of 110 children from oral health care centers, representing a general population. Construct validity was assessed by comparing SRBD scores between the PSDB group and the control group. Criterion validity was determined by sensitivity, specificity, and the Area Under the Curve of a Receiver Operating Characteristic curve (AUC-ROC) for the SRBD scales and subscales in relation to PSG-confirmed snoring and obstructive sleep apnea (OSA). Logistic regression was used to estimate SRBD's ability among other co-variables to identify PSDB.
Results:
SRBD scale scores significantly differentiated PSDB from the control group. The sensitivity and specificity for OSA were 0.92 and 0.74, respectively. For PSDB (snoring and/or OSA), sensitivity and specificity were each 0.85. The AUC for the total SRBD scale exceeded 0.87 for all PSG outcomes, showing an adequate screening performance.
Conclusion:
The Dutch SRBD scale is useful in primary care as a valid first step in screening PSDB.
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