title: Utility of screening for obstructive sleep apnea syndrome in children with craniofacial disorders.
abstract: BACKGROUND
  Children with craniofacial disorders are at increased risk for obstructive sleep apnea syndrome. Methods for diagnosing obstructive sleep apnea syndrome in this population remain controversial. Sleep studies are the criterion standard but are impractical for all patients. The utility of obstructive sleep apnea syndrome questionnaires such as the Pediatric Sleep Questionnaire is unknown in children with craniofacial disorders. The authors hypothesized that the Pediatric Sleep Questionnaire would be a sensitive tool for detecting obstructive sleep apnea syndrome in children with craniofacial abnormalities.
  
  
  METHODS
  A retrospective review of consecutive children with diagnosed craniofacial disorders who both completed the Pediatric Sleep Questionnaire and underwent polysomnography was performed. Demographics, Pediatric Sleep Questionnaire score, and polysomnographic data were recorded. Statistical analysis included calculation of sensitivity, specificity, positive predictive value, and negative predictive value for the Pediatric Sleep Questionnaire.
  
  
  RESULTS
  Eighty-three children aged 2 to 18 years were included in the study. Of these, 44 (53.0 percent) screened positive on the Pediatric Sleep Questionnaire and 23 (27.7 percent) had polysomnographic evidence of obstructive sleep apnea syndrome, but the sensitivity of the Pediatric Sleep Questionnaire for detecting obstructive sleep apnea syndrome in this sample was only 0.57 and the specificity was 0.48. Positive predictive value and negative predictive value were 0.30 and 0.74, respectively. The correlation between the apnea hypopnea index and Pediatric Sleep Questionnaire score was 0.152 (p = 0.17).
  
  
  CONCLUSIONS
  A substantial portion of craniofacial patients referred for polysomnography was found to have obstructive sleep apnea syndrome. However, the Pediatric Sleep Questionnaire is not a good screening tool for obstructive sleep apnea syndrome in children with craniofacial conditions. More research is needed to determine which patients with craniofacial disorders should be evaluated for obstructive sleep apnea syndrome by polysomnography or other means.
  
  
  METHODS
  Diagnostic, II.
authors.affiliation: Philadelphia, Pa. From the Divisions of Pulmonary Medicine and Plastic and Reconstructive Surgery, the Clinical and Translational Research Center, and the Sleep Center, The Children's Hospital of Philadelphia; and the Perelman School of Medicine at the University of Pennsylvania.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Cielo
authors.forename: Jason
authors.initials: J
authors.lastname: Silvestre
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Paliga
authors.forename: Meg
authors.initials: M
authors.lastname: Maguire
authors.forename: Paul R
authors.initials: PR
authors.lastname: Gallagher
authors.forename: Carole L
authors.initials: CL
authors.lastname: Marcus
authors.forename: Jesse A
authors.initials: JA
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000209:etiology; D011795:Surveys and Questionnaires