Can a clinical score be used to screen for childhood OSAS?

¹ Hospital practitioner, Sleep and Respiration Functional Unit, Physiology-Algology-Somnology Dept., Saint-Antoine Hospital, Paris, France
² Hospital practitioner, Sleep and Respiration Functional Unit, Saint-Antoine Hospital, Paris, France – President of the French Society of Dental Sleep Medicine

Address for correspondence: Xuan-Lan Nguyen 184 Rue du Faubourg Saint-Antoine – 75012 Paris, France. E-mail: xuan-lan.nguyen@sat.aphp.fr

Received: 28 January 2015
Accepted: 20 February 2015

Abstract

Pediatric obstructive sleep apnea syndrome (OSAS) is a frequent pathology (1-4% of the general population), often related to adenotonsillar hypertrophy. In France, however, access to polysomnography (PSG) is limited, leading to underdiagnosis. Using a simple, reliable diagnostic tool predictive of OSAS could prioritize prescription of night sleep recordings and help decision making for adenotonsillectomy. The aim of this study was to validate a French version of the sleep apnea Severity Hierarchy Score (SHS), already validated in English in the general population, for screening of childhood OSAS.

A prospective study included 86 children (aged 7.0 ± 2.4 years; BMI Z-score, -0.71 ± 1.51; ) referred to 2 academic sleep centers, the Saint-Antoine and Trousseau hospitals (Paris, France) for assessment of sleep disordered breathing. The SHS questionnaire was filled out by the parents prior to overnight PSG. The sensitivity and specificity of the SHS were assessed according to various levels of OSAS severity.

A threshold of ≥2.75 on the SHS showed 92% sensitivity, 81% specificity and 96% negative predictive value for moderate to severe OSAS, defined by an apnea hypopnea index³ of 5/hr in the study population.