Unité Sommeil et Fonction Respiratoire, Hôpital Saint-Antoine, Paris, France.
UPMC & Inserm UMR S 1136 (EPAR team), Département de Santé Publique, Hôpital Tenon, Paris, France.
Sleep Med. 2017 Feb;30:24-28. doi: 10.1016/j.sleep.2016.01.021. Epub 2016 Mar 14.
Paediatric obstructive sleep apnoea syndrome (OSAS) is a highly prevalent condition carrying increased risk for impaired cognitive and cardiovascular function. The standard diagnosis consists of full-night polysomnography (PSG), but limited access to PSG leads to substantial under-diagnosis. The use of a validated and simple diagnostic screening tool to predict OSAS could prioritise night sleep recordings in children at risk of OSAS, and help in clinical decision-making.
This study aimed to prospectively assess the performance of the French version of the severity hierarchy score (SHS) in paediatric OSAS. This score consists of a discriminative subset of six respiratory items, and has already been validated in English for screening OSAS in the general paediatric population.
A total of 96 children (mean age 7.1 ± 2.4 years; BMI z-score: -0.03 ± 1.50) were recruited; they had been were referred to two academic sleep centres in France for the putative diagnosis of sleep-disordered breathing. The parents completed the SHS questionnaire prior to PSG. Sensitivity and specificity of the SHS for detecting moderate OSAS, defined by an apnoea-hypopnoea index (AHI) of ≥5/hours of total sleep time (TST), were assessed, and ROC analysis was performed.
An SHS score of >2.75 exhibited an 82% sensitivity, 81% specificity, and 92% negative predictive value for detecting an AHI of ≥5/hour TST in the cohort.
The French version of the SHS emerged as favourably suited for the screening for OSAS in children.
小儿阻塞性睡眠呼吸暂停综合征（OSAS）是一种高发疾病，可导致认知和心血管功能受损的风险增加。标准诊断包括整夜多导睡眠图（PSG），但 PSG 的应用受限导致大量病例漏诊。使用经过验证且简单的诊断性筛查工具预测 OSAS，可以优先对有 OSAS 风险的儿童进行夜间睡眠记录，并有助于临床决策。
本研究旨在前瞻性评估法语版严重程度分层评分（SHS）在小儿 OSAS 中的表现。该评分由 6 项呼吸项目的判别子集组成，已经在英语中得到验证，用于筛查一般儿科人群中的 OSAS。
共纳入 96 名儿童（平均年龄 7.1±2.4 岁；BMI z 评分：-0.03±1.50）；他们因疑似睡眠呼吸障碍被转诊至法国的两个学术睡眠中心。父母在 PSG 前完成 SHS 问卷。评估 SHS 对检测中度 OSAS 的敏感性和特异性，中度 OSAS 定义为总睡眠时间（TST）每小时呼吸暂停低通气指数（AHI）≥5。并进行 ROC 分析。
SHS 评分>2.75 时，对检测 AHI≥5/TST 小时的敏感性为 82%、特异性为 81%、阴性预测值为 92%。
法语版 SHS 非常适合用于筛查儿童 OSAS。
