Reliability of sleep sonography in detecting upper airway obstruction in children.

In children, lymphoid hyperplasia is by far the most common cause of airway obstruction during sleep, but the determination as to presence or degree of obstruction is seldom made objectively, because of the expense and stress of polysomnography. If audio recordings are made by parents at home with standardized equipment, however, obstruction can be recognized readily. Such recordings obtained from 50 patients were computer processed and the resulting displays were independently rated by two judges. Interobserver correlation was 0.87 and split-half reliability was 0.83, demonstrating very good reliability of the processing and scoring procedures. Recordings made on successive nights were highly consistent as well (test-retest reliabilities of 0.78 and 0.86 for the two raters). This recording method, which is well accepted by parents and children, has both clinical and research value in the assessment of airway obstruction.