Chest
Original ResearchSleep DisordersScreening of Pediatric Sleep-Disordered Breathing: A Proposed Unbiased Discriminative Set of Questions Using Clinical Severity Scales
Section snippets
Materials and Methods
Data collection was approved by the University of Louisville Human Research Committee (protocol #474.99), and the Institutional Review Boards of Jefferson County Public Schools and Archdiocese of Louisville Catholic Schools. Informed consent was obtained from the legal caregiver of each participant, with assent being obtained from children > 7 years of age.
Results
We focused on the distributions of the 11 sleep questions that were significantly different across AHI groups: breathing concerns while asleep (Question [Q]4) (Kruskal-Wallis test H[5,N = 1,036] = 128.8, P = .0001), apnea during sleep (Q2) (H[5,N = 994] = 121.2, P < .00001), snoring during sleep (Q6) (H[5,N = 1,051] = 103.1, P < .00001), loudness of snoring (Q5) (H[5,N = 856] = 89.7, P < .00001), struggle breathing when asleep (Q3) (H[5,N = 1,019] = 85.9, P < .00001), shake child to breath (Q1)
Discussion
Based on commonly used subjective respiratory symptoms, a severity hierarchy of parental reported complaints has now been delineated. More specifically, a set of six ordered questions allows for fair discrimination along the SDB spectrum. Snoring and loudness of snoring are potentially valuable screening items; however, their specificity remains low to moderate across the spectrum. A high score on breathing concerns while asleep appears to be discriminative, affording a high probability of
Acknowledgments
Author contributions: Dr Spruyt: contributed to performing the analyses of the database and drafting the manuscript and approved the final version of the manuscript.
Dr Gozal: contributed to conception and design, securing the funding for the project, analysis and interpretation of data, drafting the manuscript, and revising it critically for important intellectual content, and gave final approval of the version to be published.
Financial/nonfinancial disclosures: The authors have reported to
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Funding/Support: This study was supported by the National Institutes of Health [Grant HL65270].
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