Predictability of Obstructive Sleep Apnea using a Pediatric Sleep Evaluation Tool
 

Obstructive Sleep Apnea Syndrome (OSAS) is a common medical problem in adults that is now becoming more recognized in children. The American Academy of Pediatrics (AAP) published recommendations and guidelines back in 2002 regarding the screening and diagnosis of children with OSAS. Many screening tools have been developed however they lack the sensitivity (the ability to predict) whether a child has OSAS. The medical literature was reviewed by Brietzke, Katz, and Roberson (2004) for research studies that aimed to compare the use of a screening tool and/or clinical exam to the nocturnal polysomnography (PSG) test. Conclusions of the authors were that clinical history and physical examination are not reliable for diagnosing OSAHS compared with overnight PSG. They also state there is an urgent need for the development of adequate screening tests with validated clinical outcomes. We as a pediatric otolaryngology practice have designed a study to evaluate the use of a short questionnaire to determine if it has the ability to predict OSAS.

Our research plan is to invite patients to participate who have come for consultation regarding adenotonsillectomy and have been identified as surgical candidates. We will administer our short questionnaire to the patient and his/her family at that time, prior to surgery. The patient would also then undergo a sleep study prior to surgery, here at YNHH. One month following surgery, we would have standard post-operative follow-up. Those patients who have been identified on the screening tool as still having significant findings will be followed and seen 3 months later. At that time an additional screening questionnaire and if indicated a follow-up sleep study will be administered. We will be primarily looking at the ability for our tool to predict if a child likely has OSAS. We will compare the data derived from the sleep study and use standard parameters for identification of OSAS.

 Diagnosis of Pediatric Obstructive Sleep Apnea can be difficult. Despite the potential diagnostic benefits, obtaining a PSG on every child who is evaluated for OSAS is obviously not feasible or practical. We hope that our research will help to screen effectively those children who have OSAS.