title: Utility of the pediatric sleep questionnaire and pulse oximetry as screening tools in pediatric patients with suspected obstructive sleep apnea syndrome.
abstract: Objective. To assess the screening tools in snoring patients. Material and Methods. A retrospective review of data was conducted from children between 2 and 15 years old who were referred on suspicion of obstructive sleep apnea-hypopnea (OSAH) between June 2008 and June 2011. We excluded patients with significant comorbidities. Pediatric Sleep Questionnaire (PSQ), physical exam (PE), and pulse-oximetry data were collected and correlated with the results of the nightly polygraph at home. Results. We selected 98 patients. The 22-item version of the PSQ had sensitivity of 96% and specificity of 36.8%. The overall value of the clinic predictor of OSAH (PSQ and PE together) exhibited an increased specificity 57.6% with 94.6% of sensitivity. The nocturnal home oximetry method used alone was very specific, 92.1%, but had a lower sensitivity, 77.1%. The set of clinical assessment tools used together with pulse-oximetry screening provided excellent specificity 98.1% and a positive predictive value 94.1% globally. The performance of this screening tool is related with the severity of OSAH and accuracy is better in moderate and severe cases. Conclusion. The combination of clinical assessment and pulse-oximetry screening can provide a sufficient diagnostic approach for pediatric patients with suspected OSAH at least in moderate and severe cases.
authors.affiliation: Respiratory and Allergy Unit, Paediatrics Department, Son Espases University Hospital, 07013 Palma Mallorca, Balearic Islands, Spain.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Peña-Zarza
authors.forename: Borja
authors.initials: B
authors.lastname: Osona-Rodriguez de Torres
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Gil-Sanchez
authors.forename: Joan
authors.initials: J
authors.lastname: Figuerola-Mulet