Paediatric Sleep Questionnaire for Obstructive Sleep Apnoea Syndrome Screening: Is Sleep Quality Worthy of Note?

Abstract

Obstructive sleep apnoea syndrome (OSAS) is the most severe condition on the spectrum of sleep-related breathing disorders (SRBDs). The Paediatric Sleep Questionnaire (PSQ) is one of the most used and validated screening tools, but it lacks the comprehensive assessment of some determinants of OSAS, specifically anamnestic assessment and sleep quality. This study aims to assess the accuracy of some specific items added to the original PSQ, particularly related to the patient’s anamnestic history and to the quality of sleep, for the screening of OSAS in a paediatric population living in Sicily (Italy). Fifteen specific items, divided into “anamnestic” and “related to sleep quality” were added to the original PSQ. The whole questionnaire was administered via a digital form to the parents of children at 4 schools (age range: 3–13 years). For each item, sensitivity and specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. The highest sensitivity (80.0, 95% CI: 28.4; 99.5), in combination with the highest specificity (61.1, 95% CI: 35.7; 82.7), was found for the Item 32 (“assumption of bizarre or abnormal positions during sleep”). This item was found statistically significant for predicting the occurrence of OSAS in children (p-value ≤0.003). The study demonstrates the accuracy of specific items related to sleep quality disturbance for the preliminary assessment of the disease. Although these results should be validated on a larger sample of subjects, they suggest that including the factors discriminating sleep quality could further increase the efficiency and accuracy of PSQ.

Italian Validation of the Pittsburgh Sleep Quality Index (PSQI) in a Population of Healthy Children: A Cross Sectional Study

“…The Pediatric Sleep Questionnaire (PSQ) is one of the most widely used sleep quality assessment questionnaires for children. It is divided into 10 sections with a total of 22 items and can be easily completed by the parents of children aged between 2 and 18 years [ 7 ].…”

Sleep‐disordered breathing in children seeking orthodontic care—an Australian perspective

“…6,31 It has the highest sensitivity and specificity of any screening tool for SDB and is defined as a 'useful tool', by the European Respiratory Society Task Force. 32 The use of the PSQ also has the potential to intercept children, who otherwise would go on undiagnosed for SDB, which can lead to significant, life-threatening repercussions. 4,31 Further research should be directed at administering the PSQ to other populations of children who are suspected to have SDB.…”

“…The PSQ is quick and simple to complete and is easy to interpret, allowing for further evaluation and appropriate referrals to be made 6,31 . It has the highest sensitivity and specificity of any screening tool for SDB and is defined as a ‘useful tool’, by the European Respiratory Society Task Force 32 . The use of the PSQ also has the potential to intercept children, who otherwise would go on undiagnosed for SDB, which can lead to significant, life‐threatening repercussions 4,31 …”

State of the Art in Comorbidities and Complications Associated with Sleep-Related Breathing Disorders

“…The authors highlighted how the investigation of sleep quality can be an important parameter in order to more effectively identify potential pediatric subjects at risk of OSAS. The assumption of bizarre or abnormal positions during sleep (e.g., hyperextending the neck or sitting), especially if present with other determinants that alter sleep quality, should be considered an alarm bell for the investigation of possible obstructive sleep apnoea [16].…”