Xuân-Lan Nguyên1, Pierre Lévy2, Nicole Beydon3, David Gozal4, Bernard Fleury5. 1. Unité Sommeil et Fonction Respiratoire, Hôpital Saint-Antoine, Paris, France. Electronic address: nguyenxl@wanadoo.fr. 2. UPMC & Inserm UMR S 1136 (EPAR team), Département de Santé Publique, Hôpital Tenon, Paris, France. 3. Unité Fonctionnelle d'Exploration Fonctionnelle Respiratoire et du Sommeil, Hôpital Armand-Trousseau, Groupe Hospitalier Universitaire de l'Est Parisien, (APHP), Paris, France. 4. Sections of Pediatric Sleep Medicine and Pediatric Pulmonology, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA. 5. Unité Sommeil et Fonction Respiratoire, Hôpital Saint-Antoine, Paris, France.
Abstract
BACKGROUND: 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. OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: The French version of the SHS emerged as favourably suited for the screening for OSAS in children.
BACKGROUND: 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. OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: The French version of the SHS emerged as favourably suited for the screening for OSAS in children.