title: Sleep clinical record: an aid to rapid and accurate diagnosis of paediatric sleep disordered breathing.
abstract: Overnight polysomnography (PSG) is an expensive procedure which can only be used in a minority of cases, although it remains the gold standard for the diagnosis of sleep disordered breathing (SDB). The objective of this study was to develop a simple, PSG-validated tool to screen SDB, thus reducing the use of PSG. For every participant we performed PSG and a sleep clinical record was completed. The sleep clinical record consists of three items: physical examination, subjective symptoms and clinical history. The clinical history analyses behavioural and cognitive problems. All three items were used to create a sleep clinical score (SCS). We studied 279 children, mean ± SD age 6.1 ± 3.1 years, 63.8% male; 27.2% with primary snoring and 72.8% with obstructive sleep apnoea (OSA) syndrome. The SCS was higher in the OSA syndrome group compared to the primary snoring group (8.1 ± 9.6 versus 0.4 ± 0.3, p<0.005), correlated with apnoea/hypopnoea index (p=0.001) and had a sensitivity of 96.05%. Positive and negative likelihood ratios were 2.91 and 0.06, respectively. SCS may effectively be used to screen patients as candidates for PSG study for suspected OSA syndrome, and to enable those with a mild form of SDB to receive early treatment.
authors.affiliation: Paediatric Dept, Faculty of Medicine, La Sapienza University, Rome, Italy. mariapia.villa@uniroma1.it
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Villa
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Paolino
authors.forename: Rosa
authors.initials: R
authors.lastname: Castaldo
authors.forename: Nicola
authors.initials: N
authors.lastname: Vanacore
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rizzoli
authors.forename: Silvia
authors.initials: S
authors.lastname: Miano
authors.forename: Marco
authors.initials: M
authors.lastname: Del Pozzo
authors.forename: Marilisa
authors.initials: M
authors.lastname: Montesano
mesh_terms: D000886:Anthropometry; D019540:Area Under Curve; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010808:Physical Examination; D017286:Polysomnography / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000175:diagnosis*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D012913:Snoring / Q000175:diagnosis*; D011795:Surveys and Questionnaires