Pediatric Sleep Survey Instrument--a screening tool for sleep disordered breathing.
OBJECTIVE
The aim of this study was to assess the construct validity and clinical application of the Pediatric Sleep Survey Instrument (PSSI) as a tool to screen for sleep disordered breathing (SDB) in children.


METHODS
Polysomnography (PSG) outcomes and PSSI subscale scores were compared between a clinical cohort (N = 87, 5-10 years, 62 M/25 F) and a nonsnoring community sample (N = 55, 5-10 years, 28 M/27 F). Group comparisons assessed the ability of the PSSI subscales to discriminate between the clinical and community cohorts. Receiver operating characteristic (ROC) curves assessed construct validity, with the Apnea/Hypopnea Index (AHI) >5 events/h, OSA-18 score >60, and Pediatric Daytime Sleepiness Scale (PDSS) above the 70th percentile as the target references.


RESULTS
The clinical group had more respiratory events, respiratory-related arousals, fragmented sleep, and lower oxygen saturation nadir than the community group (p < 0.001 for all). PSSI subscale scores of Morning Tiredness, Night Arousals, SDB, and Restless Sleep were higher (p < 0.001 for all) in the clinical cohort, confirming the tool's ability to identify clinically relevant sleep problems. ROC curves confirmed the diagnostic accuracy of the SDB subscale against an AHI > 5 events/h (area under the curve (AUC) = 0.7), an OSA-18 score >60 (AUC = 0.7), and a PDSS score in the 70th percentile (AUC = 0.8). The Morning Tiredness subscale accurately predicted a PDSS score in the 70th percentile (AUC = 0.8). A cutoff score of 5 on the SDB subscale showed a sensitivity of 0.94 and a specificity of 0.76, correctly identifying 77 and 100 % of the clinical and community cohorts, respectively.


CONCLUSIONS
The PSSI Sleep Disordered Breathing subscale is a valid tool for screening SDB and daytime sleepiness in children aged 5-10 years.
Sarah N
SN
Biggs
Gillian M
GM
Nixon
Margot J
MJ
Davey
Diana C
DC
Cicua Navarro
J Declan
JD
Kennedy
Kurt
K
Lushington
Rosemary S C
RS
Horne
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening; D017286:Polysomnography; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D013021:South Australia