title: Congruence between polysomnography obstructive sleep apnea and the pediatric sleep questionnaire: fatigue and health-related quality of life in juvenile idiopathic arthritis.
abstract: To examine the congruence between polysomnography obstructive apnea hypopnea index (OAHI) and parent-reported obstructive sleep apnea (OSA) symptoms in 6- to 11-year-old children with juvenile idiopathic arthritis (JIA) and controls; and to compare fatigue and quality of life in JIA and control children based on OAHI and OSA symptoms.
  
  
  
  Sixty-eight children with JIA and 75 controls and a parent participated. Children underwent one night of polysomnography in a sleep laboratory. Parents completed the sleep-related breathing disorders scale-pediatric sleep questionnaire (PSQ), and both children and parents completed the Pediatric Quality of Life Generic Core Scale and the Multidimensional Fatigue Scale.
  
  
  
  In JIA, 86% who met the OAHI clinical criteria for OSA (≥1.5) were above the PSQ OSA symptom cut-off score with a sensitivity of 0.86 and a specificity of 0.28. In the control group, 63% who met the OAHI clinical criteria for OSA were above the PSQ OSA symptom cut-off score, with a sensitivity of 0.63 and a specificity of 0.42. All children above both the clinical criteria for OAHI and OSA symptom cut-off score had the most impaired quality of life and greater fatigue compared to those below both the clinical criteria for OAHI and the OSA symptom cut-off score.
  
  
  
  Children who meet clinical criteria for OSA and also scored high on a parent-reported screening tool for OSA symptoms had the most impaired quality of life and more fatigue. The PSQ has potential to identify children at risk for OSA.
authors.affiliation: Department of Family and Child Nursing, School of Nursing, University of Washington, Box 357262, Seattle, WA, 98195-7266, USA. teward@uw.edu.
authors.forename: Teresa M
authors.identifier: 0000-0002-8651-4066
authors.initials: TM
authors.lastname: Ward
authors.affiliation: Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Maida Lynn
authors.initials: ML
authors.lastname: Chen
authors.affiliation: Department of Family and Child Nursing, School of Nursing, University of Washington, Box 357262, Seattle, WA, 98195-7266, USA.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Landis
authors.affiliation: Division of Rheumatology, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ringold
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Dean W
authors.initials: DW
authors.lastname: Beebe
authors.affiliation: Department of Family and Child Nursing, School of Nursing, University of Washington, Box 357262, Seattle, WA, 98195-7266, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Pike
authors.affiliation: Division of Rheumatology, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Wallace
mesh_terms: D001171:Arthritis, Juvenile / Q000150:complications / Q000523:psychology*; D002648:Child; D002662:Child Health Services; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D011788:Quality of Life; D015203:Reproducibility of Results; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Fatigue; Health-related quality of life; Juvenile idiopathic arthritis; Obstructive sleep apnea; Patient-reported outcomes; Pediatric sleep questionnaire