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Type: Journal article
Title: Pediatric Sleep Survey Instrument - a screening tool for sleep disordered breathing
Author: Biggs, S.
Nixon, G.
Davey, M.
Cicua Navarro, D.
Kennedy, J.
Lushington, K.
Horne, R.
Citation: Sleep and Breathing: international journal of the science and practice of sleep medicine, 2014; 18(2):383-390
Publisher: Springer-Verlag
Issue Date: 2014
ISSN: 1520-9512
Statement of
Sarah N. Biggs, Gillian M. Nixon, Margot J. Davey, Diana C. Cicua Navarro, J. Declan Kennedy, Kurt Lushington, Rosemary S. C. Horne
Abstract: Purpose: The aim of this study was to assess the construct validity and clinical application of the Pediatric Sleep Survey Instrument (PSSI) as a tool to screen for sleep disordered breathing (SDB) in children. Methods: Polysomnography (PSG) outcomes and PSSI subscale scores were compared between a clinical cohort (N = 87, 5–10 years, 62 M/25 F) and a nonsnoring community sample (N = 55, 5–10 years, 28 M/27 F). Group comparisons assessed the ability of the PSSI subscales to discriminate between the clinical and community cohorts. Receiver operating characteristic (ROC) curves assessed construct validity, with the Apnea/Hypopnea Index (AHI) >5 events/h, OSA-18 score >60, and Pediatric Daytime Sleepiness Scale (PDSS) above the 70th percentile as the target references. Results: The clinical group had more respiratory events, respiratory-related arousals, fragmented sleep, and lower oxygen saturation nadir than the community group (p < 0.001 for all). PSSI subscale scores of Morning Tiredness, Night Arousals, SDB, and Restless Sleep were higher (p < 0.001 for all) in the clinical cohort, confirming the tool’s ability to identify clinically relevant sleep problems. ROC curves confirmed the diagnostic accuracy of the SDB subscale against an AHI > 5 events/h (area under the curve (AUC) = 0.7), an OSA-18 score >60 (AUC = 0.7), and a PDSS score in the 70th percentile (AUC = 0.8). The Morning Tiredness subscale accurately predicted a PDSS score in the 70th percentile (AUC = 0.8). A cutoff score of 5 on the SDB subscale showed a sensitivity of 0.94 and a specificity of 0.76, correctly identifying 77 and 100 % of the clinical and community cohorts, respectively. Conclusion: The PSSI Sleep Disordered Breathing subscale is a valid tool for screening SDB and daytime sleepiness in children aged 5–10 years.
Keywords: Pediatric Sleep Questionnaire; validation; children; Sleep disordered breathing; daytime sleepiness
Rights: © Springer-Verlag Berlin Heidelberg 2013
DOI: 10.1007/s11325-013-0897-1
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Paediatrics publications

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