Ishman Stacey, Heubi Christine, Jenkins Todd, Michalsky Marc, Simakajornboon Narong, Inge Thomas
Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Obesity (Silver Spring). 2016 Nov;24(11):2392-2398. doi: 10.1002/oby.21623. Epub 2016 Sep 15.
Obstructive sleep apnea (OSA) is reported in 70% of adolescents who present for bariatric surgery. The Pediatric Sleep Questionnaire (PSQ) was developed to identify children at risk for OSA but is not validated in adolescents with obesity. The aims of this study were: (1) to assess validity of the PSQ to detect OSA and (2) to determine the correlation between anthropometric and polysomnography measurements.
A cross-sectional assessment of Teen-Longitudinal Assessment of Bariatric Surgery participants at high risk for OSA was performed. Participants completed an overnight polysomnography, and caregivers completed the PSQ.
Forty-five participants (84% female, 78% Caucasian, mean age = 16.7 ± 1.5 years) were evaluated. Mean BMI was 51.3 ± 7.7 kg/m and mean obstructive apnea-hypopnea index (oAHI) was 6.1 ± 5.9 events/h. For diagnosis of OSA (oAHI ≥5), the total PSQ score sensitivity, specificity, and positive predictive value (PPV) were 86%, 38%, and 55%, respectively. For snoring >50% of the time, PPV was 84%, sensitivity was 64%, and specificity was 43%. Sagittal abdominal diameter correlated with oAHI and oxygen saturation nadir (ρ = 0.34, P = 0.027), whereas BMI, neck, and waist circumference correlated with neither.
The PSQ demonstrated low specificity, and PPV and the question regarding snoring >50% of the time did not effectively identify OSA. Sagittal abdominal diameter correlated with oAHI and oxygen saturation nadir.
据报道,接受减肥手术的青少年中70%患有阻塞性睡眠呼吸暂停(OSA)。儿科睡眠问卷(PSQ)旨在识别有OSA风险的儿童,但未在肥胖青少年中得到验证。本研究的目的是:(1)评估PSQ检测OSA的有效性;(2)确定人体测量学与多导睡眠图测量值之间的相关性。
对有OSA高风险的减肥手术青少年长期纵向评估参与者进行横断面评估。参与者完成了整夜多导睡眠图检查,护理人员完成了PSQ。
对45名参与者(84%为女性,78%为白种人,平均年龄 = 16.7 ± 1.5岁)进行了评估。平均体重指数(BMI)为51.3 ± 7.7 kg/m²,平均阻塞性呼吸暂停低通气指数(oAHI)为6.1 ± 5.9次/小时。对于OSA诊断(oAHI≥5),PSQ总分的敏感性、特异性和阳性预测值(PPV)分别为86%、38%和55%。对于打鼾时间超过50%的情况,PPV为84%,敏感性为64%,特异性为43%。腹矢状径与oAHI和最低氧饱和度相关(ρ = 0.34,P = 0.027),而BMI、颈部和腰围均与之无关。
PSQ显示出低特异性,PPV以及关于打鼾时间超过50%的问题未能有效识别OSA。腹矢状径与oAHI和最低氧饱和度相关。