Abstract
Introduction
Polysomnography (PSG) is the gold standard for the diagnosis of Obstructive Sleep Apnea (OSA). However, it is expensive and not available everywhere. For these reasons, alternatives to full PSG for the evaluation of suspected OSAS are often sought. The aim of our study is to develop a simple tool to screen OSA, thus reducing the use of PSG.
Methods
Children with suspected OSA referred to our Pediatric Sleep Centre from September 2012 to September 2013 were included. Each patient underwent Sleep Clinical Record (SCR), full PSG, and nocturnal pulse oximetry. A diagnosis of OSA was made in children with an Apnea/Hypopnea Index (AHI) ≥1 ev/h. A SCR score ≥ 6.5 and a McGill Oximetry Score (MOS) ≥ 2 were considered positive.
Results
We enrolled 285 children, mean age 6.2 ± 3.1, 187 (65.6%) male. 52 children (18.2%) showed MOS ≥ 2 with a sensitivity of 20.5% and specificity of 97.2%. 227 children (79.6%) had SCR score ≥ 6.5 with a sensitivity of 81.1% and specificity of 30.5%.
48 children (16.8%) showed positive SCR and MOS; all of them received a diagnosis of OSA at the PSG, reaching a specificity of 100%. Sensitivity was 52%; positive and negative predictive value were respectively 100% and 18.5%.
Conclusion
The combined use of SCR and nocturnal pulse oximetry with MOS may represent a valid alternative to full PSG.
- © 2014 ERS