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Accuracy of the sleep clinical record for the diagnosis of pediatric moderate-to-severe obstructive sleep apnea syndrome

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

The sleep clinical record (SCR) has been used to diagnose obstructive sleep apnea syndrome (OSAS) in children when access to polysomnography (PSG) is limited. Our aim was to determine the best SCR score that could facilitate diagnosis of moderate-to-severe OSAS in children with snoring.

Methods

Healthy children with history of snoring, who were referred for PSG, were prospectively recruited. The SCR score was calculated. Receiver operating characteristic curves (ROCs) were plotted to determine the area under curve (AUC), and the optimum SCR cutoff value was determined using the Youden index (J).

Results

Two hundred and seventy-three children were recruited (mean age 6.3 ± 2.5 years; median obstructive apnea–hypopnea index 1.5 episodes/h; range 0–61.1). The mean SCR score was 6.9 ± 3.6. Forty-six children had moderate-to-severe OSAS. Subjects with moderate-to-severe OSAS had a significantly higher mean SCR score (10.2 ± 2.9) than those with mild OSAS (6.2 ± 3.3; P < 0.001). Based on the plotted ROC, the AUC was 0.811 (95% confidence interval: 0.747–0.876; P < 0.001). Calculation of J, based on its ROC coordinates, indicated that the optimum cutoff SCR score to predict moderate-to-severe OSAS was 8.25, corresponding to a sensitivity of 83% and a specificity of 70%.

Conclusion

Among children with history of snoring, an SCR score above 8.25 can identify those with moderate-to-severe OSAS.

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Authors and Affiliations

  1. Sleep Disorders Laboratory, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece

    Anna Maria Mylona, Georgia Rapti, Konstantinos Gourgoulianis & Emmanouil I. Alexopoulos

  2. Department of Pediatrics, University of Thessaly School of Medicine and Larissa University Hospital, P.O. Box 1425, 41110, Larissa, Greece

    Anna Maria Mylona & Emmanouil I. Alexopoulos

  3. Department of Respiratory Medicine, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece

    George Vavougios & Konstantinos Gourgoulianis

  4. Department of Otorhinolaryngology, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece

    Vasileios A. Lachanas & Charalambos Skoulakis

  5. Department of Biochemistry, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece

    Panagiotis Liakos

  6. First Department of Pediatrics, Division of Pediatric Pulmonology, National and Kapodistrian University of Athens School of Medicine and Agia Sofia Children’s Hospital, Athens, Greece

    Athanasios G. Kaditis

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  1. Anna Maria Mylona
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Correspondence to Emmanouil I. Alexopoulos.

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Ethical approval

The Larissa University Hospital Scientific Council gave its approval to this research (6/13–03-2018). This study was carried out in line with the 1964 Declaration of Helsinki and its later revisions, or similar ethical norms.

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Mylona, A.M., Rapti, G., Vavougios, G. et al. Accuracy of the sleep clinical record for the diagnosis of pediatric moderate-to-severe obstructive sleep apnea syndrome. Sleep Breath 26, 763–769 (2022). https://doi.org/10.1007/s11325-021-02471-4

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  • DOI: https://doi.org/10.1007/s11325-021-02471-4

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