Health and Movement Consultation, Division of Pediatric Specialties, Department of Pediatrics, Gynecology and Obstetrics, Switzerland.
Pediatric Cardiology Unit, Division of Pediatric Specialties, Department of Pediatrics, Gynecology and Obstetrics, Switzerland.
Int J Pediatr Otorhinolaryngol. 2021 Apr;143:110635. doi: 10.1016/j.ijporl.2021.110635. Epub 2021 Jan 27.
The prevalence of obstructive sleep apnea syndrome (OSAS) in children referred for sleep-disordered breathing reaches up to 59%. We aimed to test the adequacy of a questionnaire compared to home respiratory polygraphy (HRP), in 45 subjects (5-16 years-old), without maxillofacial malformations nor other comorbidities, presenting with symptoms compatible with OSAS.
All children passed a 12-items questionnaire (Obstructive Airway Child test: OACT) and the HRP. OSAS was classified in severity according to the apnea-hypopnea index (AHI).
With HRP, 60% and 15% children were detected to have at least mild (AHI ≥1) and moderate (AHI >5) OSAS, respectively. The sensitivity of the questionnaire to detect mild and moderate OSAS was good (93% and 71%, respectively) but the specificity was very low (11% and 34%). However, an OACT score under 61 showed a very good negative predictive value for moderate and severe OSAS (87%). With the questionnaire, we could have avoided a complementary PSG or HRP in 25/45 (56%) of our subjects as in children with mild OSAS and without comorbidities only clinical observation is usually advised.
The OACT questionnaire has shown to be a good and quick instrument to exclude moderate and severe OSAS in our population of children without maxillofacial malformations. Indeed children scoring under 61 could avoid a constraining and expensive sleep exam. However, if the score is above this cut-off, the performance to recognize OSAS is low and the child's evaluation must be completed by a HRP or PSG.
在因睡眠呼吸障碍而就诊的儿童中，阻塞性睡眠呼吸暂停综合征（OSAS）的患病率高达 59%。我们旨在比较问卷和家庭呼吸多导睡眠图（HRP）在 45 名（5-16 岁）无颌面畸形或其他合并症、表现出与 OSAS 相符症状的受试者中的适用性。
所有儿童均通过 12 项问卷（阻塞性气道儿童测试：OACT）和 HRP 进行检查。根据呼吸暂停低通气指数（AHI）将 OSAS 分为严重程度。
根据 HRP，60%和 15%的儿童分别被检出至少有轻度（AHI≥1）和中度（AHI>5）OSAS。问卷对轻度和中度 OSAS 的敏感性良好（分别为 93%和 71%），但特异性非常低（分别为 11%和 34%）。然而，OACT 评分低于 61 分对中重度 OSAS 具有很好的阴性预测值（87%）。通过问卷，我们可以避免对 45 名儿童中的 25 名（56%）进行补充 PSG 或 HRP，因为对于轻度 OSAS 且无合并症的儿童，通常仅建议进行临床观察。
OACT 问卷已被证明是一种很好且快速的工具，可以排除我们无颌面畸形儿童中中重度 OSAS。实际上，评分低于 61 分的儿童可以避免进行繁琐且昂贵的睡眠检查。但是，如果评分高于此截止值，则识别 OSAS 的性能较低，必须通过 HRP 或 PSG 对儿童进行评估。
