Anna Maria Mylona1,2, Georgia Rapti1, George Vavougios3, Vasileios A Lachanas4, Panagiotis Liakos5, Charalambos Skoulakis4, Athanasios G Kaditis6, Konstantinos Gourgoulianis1,3, Emmanouil I Alexopoulos7,8. 1. Sleep Disorders Laboratory, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece. 2. Department of Pediatrics, University of Thessaly School of Medicine and Larissa University Hospital, P.O. Box 1425, 41110, Larissa, Greece. 3. Department of Respiratory Medicine, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece. 4. Department of Otorhinolaryngology, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece. 5. Department of Biochemistry, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece. 6. First Department of Pediatrics, Division of Pediatric Pulmonology, National and Kapodistrian University of Athens School of Medicine and Agia Sofia Children's Hospital, Athens, Greece. 7. Sleep Disorders Laboratory, University of Thessaly School of Medicine and Larissa University Hospital, Larissa, Greece. ealexop@yahoo.com. 8. Department of Pediatrics, University of Thessaly School of Medicine and Larissa University Hospital, P.O. Box 1425, 41110, Larissa, Greece. ealexop@yahoo.com.
Abstract
PURPOSE: The sleep clinical record (SCR) has been used to diagnose obstructive sleep apnea syndrome (OSAS) in children when access to polysomnography (PSG) is limited. Our aim was to determine the best SCR score that could facilitate diagnosis of moderate-to-severe OSAS in children with snoring. METHODS: Healthy children with history of snoring, who were referred for PSG, were prospectively recruited. The SCR score was calculated. Receiver operating characteristic curves (ROCs) were plotted to determine the area under curve (AUC), and the optimum SCR cutoff value was determined using the Youden index (J). RESULTS: Two hundred and seventy-three children were recruited (mean age 6.3 ± 2.5 years; median obstructive apnea-hypopnea index 1.5 episodes/h; range 0-61.1). The mean SCR score was 6.9 ± 3.6. Forty-six children had moderate-to-severe OSAS. Subjects with moderate-to-severe OSAS had a significantly higher mean SCR score (10.2 ± 2.9) than those with mild OSAS (6.2 ± 3.3; P < 0.001). Based on the plotted ROC, the AUC was 0.811 (95% confidence interval: 0.747-0.876; P < 0.001). Calculation of J, based on its ROC coordinates, indicated that the optimum cutoff SCR score to predict moderate-to-severe OSAS was 8.25, corresponding to a sensitivity of 83% and a specificity of 70%. CONCLUSION: Among children with history of snoring, an SCR score above 8.25 can identify those with moderate-to-severe OSAS.
PURPOSE: The sleep clinical record (SCR) has been used to diagnose obstructive sleep apnea syndrome (OSAS) in children when access to polysomnography (PSG) is limited. Our aim was to determine the best SCR score that could facilitate diagnosis of moderate-to-severe OSAS in children with snoring. METHODS: Healthy children with history of snoring, who were referred for PSG, were prospectively recruited. The SCR score was calculated. Receiver operating characteristic curves (ROCs) were plotted to determine the area under curve (AUC), and the optimum SCR cutoff value was determined using the Youden index (J). RESULTS: Two hundred and seventy-three children were recruited (mean age 6.3 ± 2.5 years; median obstructive apnea-hypopnea index 1.5 episodes/h; range 0-61.1). The mean SCR score was 6.9 ± 3.6. Forty-six children had moderate-to-severe OSAS. Subjects with moderate-to-severe OSAS had a significantly higher mean SCR score (10.2 ± 2.9) than those with mild OSAS (6.2 ± 3.3; P < 0.001). Based on the plotted ROC, the AUC was 0.811 (95% confidence interval: 0.747-0.876; P < 0.001). Calculation of J, based on its ROC coordinates, indicated that the optimum cutoff SCR score to predict moderate-to-severe OSAS was 8.25, corresponding to a sensitivity of 83% and a specificity of 70%. CONCLUSION: Among children with history of snoring, an SCR score above 8.25 can identify those with moderate-to-severe OSAS.
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Authors: Maria Pia Villa; Nicoletta Pietropaoli; Maria Chiara Supino; Ottavio Vitelli; Jole Rabasco; Melania Evangelisti; Marco Del Pozzo; Athanasios G Kaditis Journal: JAMA Otolaryngol Head Neck Surg Date: 2015-11 Impact factor: 6.223