Paediatric Dept, Faculty of Medicine, La Sapienza University, Rome, Italy.
Eur Respir J. 2013 Jun;41(6):1355-61. doi: 10.1183/09031936.00215411. Epub 2012 Sep 27.
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.
整夜多导睡眠图（PSG）是一种昂贵的检查，仅能用于少数病例，尽管它仍然是睡眠呼吸障碍（SDB）诊断的金标准。本研究旨在开发一种简单的、经过 PSG 验证的工具来筛查 SDB，从而减少 PSG 的使用。我们对每一位参与者都进行了 PSG 检查，并完成了睡眠临床记录。睡眠临床记录包括三个项目：体格检查、主观症状和临床病史。临床病史分析行为和认知问题。这三个项目都被用于创建睡眠临床评分（SCS）。我们研究了 279 名儿童，平均年龄为 6.1±3.1 岁，男性占 63.8%；27.2%为单纯性打鼾，72.8%为阻塞性睡眠呼吸暂停（OSA）综合征。OSA 综合征组的 SCS 高于单纯性打鼾组（8.1±9.6 与 0.4±0.3，p<0.005），与呼吸暂停/低通气指数（apnoea/hypopnoea index，AHI）相关（p=0.001），且具有 96.05%的灵敏度。阳性和阴性似然比分别为 2.91 和 0.06。SCS 可有效用于筛选疑似 OSA 综合征患者进行 PSG 研究的候选者，并使那些患有轻度 SDB 的患者能够接受早期治疗。
