Stacey Ishman1,2, Christine Heubi3, Todd Jenkins4, Marc Michalsky5, Narong Simakajornboon6, Thomas Inge4. 1. Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. stacey.ishman@cchmc.org. 2. Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. stacey.ishman@cchmc.org. 3. Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. 4. Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. 5. Division of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA. 6. Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Abstract
OBJECTIVE: 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. METHODS: 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. RESULTS: Forty-five participants (84% female, 78% Caucasian, mean age = 16.7 ± 1.5 years) were evaluated. Mean BMI was 51.3 ± 7.7 kg/m2 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. CONCLUSIONS: 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.
OBJECTIVE: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. METHODS: 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. RESULTS: Forty-five participants (84% female, 78% Caucasian, mean age = 16.7 ± 1.5 years) were evaluated. Mean BMI was 51.3 ± 7.7 kg/m2 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. CONCLUSIONS: 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.
Authors: Ronald D Chervin; Robert A Weatherly; Susan L Garetz; Deborah L Ruzicka; Bruno J Giordani; Elise K Hodges; James E Dillon; Kenneth E Guire Journal: Arch Otolaryngol Head Neck Surg Date: 2007-03
Authors: Akram Khan; Wendy C King; Emma J Patterson; Jamie Laut; William Raum; Anita P Courcoulas; Charles Atwood; Bruce M Wolfe Journal: J Clin Sleep Med Date: 2013-01-15 Impact factor: 4.062
Authors: Edward O Bixler; Alexandros N Vgontzas; Hung-Mo Lin; Duanping Liao; Susan Calhoun; Antonio Vela-Bueno; Fred Fedok; Vukmir Vlasic; Gavin Graff Journal: Sleep Date: 2009-06 Impact factor: 5.849
Authors: Thomas H Inge; Meg H Zeller; Todd M Jenkins; Michael Helmrath; Mary L Brandt; Marc P Michalsky; Carroll M Harmon; Anita Courcoulas; Mary Horlick; Stavra A Xanthakos; Larry Dolan; Mark Mitsnefes; Sean J Barnett; Ralph Buncher Journal: JAMA Pediatr Date: 2014-01 Impact factor: 16.193
Authors: Janey S A Pratt; Allen Browne; Nancy T Browne; Matias Bruzoni; Megan Cohen; Ashish Desai; Thomas Inge; Bradley C Linden; Samer G Mattar; Marc Michalsky; David Podkameni; Kirk W Reichard; Fatima Cody Stanford; Meg H Zeller; Jeffrey Zitsman Journal: Surg Obes Relat Dis Date: 2018-03-23 Impact factor: 4.734
Authors: Jill L Kaar; Nazeen Morelli; Samuel P Russell; Ishaah Talker; Jaime M Moore; Thomas H Inge; Kristen J Nadeau; Stephen M M Hawkins; Mark S Aloia; Stacey L Simon Journal: Surg Obes Relat Dis Date: 2020-12-17 Impact factor: 4.734