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Is the Pediatric Sleep Questionnaire sensitive for sleep-disordered breathing in children with complex chronic disease?

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

Sleep-disordered breathing (SDB) is a disease defined by breathing or breathing irregularities while asleep. The current study examines the association between results of polysomnography (PSG) and the Pediatric Sleep Questionnaire (PSQ), and the specificity and sensitivity of the PSQ for obstructive sleep apnea (OSA) in patients with chronic illnesses.

Methods

Demographic and clinical attributes, in addition to PSQ and PSG outcomes were examined retrospectively among patients who underwent polysomnography (PSG) at our facility between 2012 and 2021.

Results

Of 745 patients included in the study, 462 (62%) were male. The median age was 81 months (34–151 months). 117 of the patients (15/8%) had chronic lung disease, and 80 (10.7%) had cerebral palsy. The most common indications for PSG were symptoms of OSA (n = 426; 57.1%). According to obstructive apnea-hypopnea index (AHI), 361 patients (48.5%) had normal PSG. The median PSQ score was 0.40 (0.22–0.57). The sensitivity and specificity of the PSQ were 71.8% and 40.4%, respectively, for individuals aged 2 to 18 years. Among the disease subgroups, the cerebral palsy group had the highest sensitivity of PSQ (88.8%) for diagnosis of OSA.

Conclusion

Questionnaires for evaluating SDB are not sensitive or specific for identification of OSA in children with chronic conditions, and PSG remains the best method.

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Data availability

I confirm I have included a data availability statement in my main manuscript file.

The datasets generated during and analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

SDB:

Sleep-disordered breathing

OSAS:

Obstructive sleep apnea syndrome

CSA:

Central sleep apnea

ICSD-3:

International Classification of Sleep Disorders – Third Edition

PSG:

Polysomnography

PSQ:

Pediatric Sleep Questionnaire

AASM:

American Academy of Sleep Medicine

TST:

Total sleep time

AI:

Apnea index

HI:

Hypopnea index

AHI:

Apnea-hypopnea index

oAHI:

Obstructive apnea–hypopnea index

CAI:

Central apnea index

ODI:

Oxygen desaturation index

PAP:

Positive airway pressure

CPAP:

Continuous positive airway pressure

BiPAP:

Bilevel positive airway pressure

BMI:

Body mass ındex

PWS:

Prader-Willi syndrome

REM:

Rapid eye movement

WASO:

Waking up after sleep onset

SL:

Sleep latency

SE:

Sleep efficiency

NMD:

Neuromuscular disease

PPV:

Positive predictive value

NPV:

Negative predictive value

CI:

Confidence interval

ENT:

Ear, nose, and throat

NIV:

Non-invasive ventilation

ERS:

European Respiratory Society

DS:

Down syndrome

AT:

Adenotonsillectomy

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Acknowledgements

We thank Prof Dr. Pınar Ay (Marmara University School of Medicine, Division of Public Health) for helping with statistical analysis in our study. There is no funding for this study.

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Authors and Affiliations

  1. Division of Pediatric Pulmonology, Marmara University Hospital, Fevzi Cakmak Mah. Mimar Sinan Cad. No:41 Pendik, Istanbul, Turkey

    Mine Kalyoncu, Muruvvet Yanaz, Aynur Gulieva, Almala Pınar Ergenekon, Merve Selçuk, Yasemin Gokdemir, Fazilet Karakoç, Bulent Karadag & Ela Erdem Eralp

  2. Marmara University School of Medicine, Istanbul, Turkey

    Nurtuğ Namlı

  3. Division of Pediatric Pulmonology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey

    Cansu Yilmaz Yegit

  4. Division of Pediatric Pulmonology, Başkent University School of Medicine, Istanbul, Turkey

    Emine Atağ

  5. Division of Pediatric Pulmonology, Istanbul University School of Medicine, Istanbul, Turkey

    Nilay Baş İkizoğlu

  6. Sleep Laboratory of Pediatric Pulmonology, Marmara University School of Medicine, Istanbul, Turkey

    Meltem Sabancı & Kadir Lale

  7. Division of Respiratory Medicine, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

    Refika Ersu

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  1. Mine Kalyoncu
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Corresponding author

Correspondence to Mine Kalyoncu.

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Ethics approval

Approval was obtained from the ethics committee of Marmara University. The study was performed by the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Kalyoncu, M., Namlı, N., Yegit, C.Y. et al. Is the Pediatric Sleep Questionnaire sensitive for sleep-disordered breathing in children with complex chronic disease?. Sleep Breath 28, 331–337 (2024). https://doi.org/10.1007/s11325-023-02915-z

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  • DOI: https://doi.org/10.1007/s11325-023-02915-z

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