Comparing two pediatric sleep questionnaires: The Pediatric Sleep Questionnaire (PSQ) and a set of 6 hierarchically arranged questions (6Q).

OBJECTIVE: To compare the Pediatric Sleep Questionnaire (PSQ) and a less time-consuming set of 6 hierarchically arranged questions (6Q) as they relate to the pre-test probability for sleep apnea in pediatric patients. METHODS: Parents of 116 subjects between the ages of 7 and 17 answered two sleep questionnaires (the PSQ and the 6Q) distributed in random order before the subjects had sleep studies. Correlation coefficients were used for apnea-hypopnea index (AHI) prediction, while the area under the curve (AUC) was calculated for sleep apnea classification prediction. RESULTS: The 6Q showed statistical significance, while the more commonly used PSQ did not, both in terms of correlating with AHI (rho = 0.294, p = 0.001) and predicting moderate and severe sleep apnea (AUC = 0.650 and 0.788, respectively). CONCLUSION: Although additional field validation is required, these pediatric sleep questionnaires are sensitive and easy-to-use screening tools that can greatly help in the screening for pediatric sleep apnea.

Relating three-dimensional airway measurements to the apnea-hypopnea index in pediatric sleep apnea patients.

OBJECTIVES: (a) To evaluate three-dimensional radiographic airway analysis as it relates to the pre-test probability for sleep apnea in pediatric patients, and (b) to develop cut-off values for measurements showing promising results. SETTING AND SAMPLE POPULATION: A consecutive series of pediatric patients between the ages of 7 and 17 years, referred for a sleep study were recruited. Cone beam computed tomography (CBCT) scans were acquired for 103 subjects within one month following the sleep study. METHODS: Three-dimensional airway analysis was performed including volumetric, area and linear measurements. Correlations with the apnea-hypopnea index (AHI) and receiver operating characteristic (ROC) curves were constructed. Sensitivity and specificity were calculated for prediction of AHI ≥ 5 and AHI ≥ 10. RESULTS: 99 CBCT scans were included (median age = 11 years). The nasopharyngeal volume (NPV) significantly correlated with AHI (rho≈-0.4, P < .05). In subjects aged 7-11 years, proposed cut-off values for NPV are 2400mm3 and 1600mm3 for AHI ≥ 5 and AHI ≥ 10, respectively. In subjects aged 12-17 years, proposed cut-off values for NPV are 3500mm3 and 2700mm3 for AHI ≥ 5 and AHI ≥ 10, respectively. Oropharyngeal cross-sectional area (OCSA) demonstrated significant predictive value in ROC curve analysis, and cut-off values for this airway measure are also proposed. CONCLUSIONS: Contrary to findings in adults, the NPV shows promise when screening for sleep apnea in children when CBCT scans are available. The OCSA might also be of value when screening for sleep apnea especially in older children.