Validation of the pediatric sleep questionnaire in children with asthma.

Objective: The prevalence of obstructive sleep apnea (OSA) is higher in children with poorly controlled asthma. We aimed to determine the validity of the Pediatric Sleep Questionnaire (PSQ) to screen for OSA in children with asthma.
Methods: This retrospective review encompassed sleep studies and medical records of asthmatic children evaluated in the sleep center at CCHMC over 13 years. Measures of validity were calculated using various cut-off values for obstructive apnea-hypopnea index (OI; >1, >2, >5) and PSQ scores (>0.33, >0.5). Correlation between PSQ and OI, PSQ and spirometry, and OI and spirometry was assessed using Spearman's correlation coefficient.
Results: One-hundred and sixty children were included (mean age 11 ± 4 years; 64% males). The mean OI was 4.2 ± 14.3 and the mean PSQ score was 0.57 ± 0.19. Thirty-eight percent of patients had a diagnosis of allergic rhinitis. A total of 70 children (43%) were obese (BMI ≥95th percentile). The correlation between OI and PSQ was statistically significant (r = 0.19, P = 0.015). Using a PSQ cutoff of 0.33, and OI cutoffs of 1, 2, and 5, the sensitivities were 81.6%, 81.6%, and 76.2%, and the specificities were 13.1%, 14.4%, and 14.4%, respectively. When the cutoff for PSQ was raised to 0.5 and using an OI of 1, the sensitivity decreased to 71.1%, but the specificity increased to 36.9%.
Conclusions: The sensitivity of PSQ in asthmatic children is high and comparable to previous studies, but the specificity is low. The PSQ may be considered a reasonable first-line screening tool for OSA in asthmatic children. Pediatr Pulmonol. 2017;52:382-389. © 2016 Wiley Periodicals, Inc.
(© 2016 Wiley Periodicals, Inc.)