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A comparison of two screening tools for paediatric obstructive sleep apnea

Untreated obstructive sleep apnea in children is associated with significant medical and psychological morbidities. Polysomnographic testing is the gold‐standard method for diagnosis of obstructive sleep apnea. However, laboratory‐based polysomnography is expensive and associated with a substantial healthcare burden. Thus, a simple valid tool to accurately identify those at high risk of obstructive sleep apnea is essential. We performed a retrospective cross‐sectional study of children referred to the Youthdale Child and Adolescent Sleep Clinic. Data were collected from questionnaires and sleep studies reports of 395 children. A comparison between two screening tools for paediatric obstructive sleep apnea – a six‐item (parent‐response) and an eight‐item IF‐SLEEPY/IM‐SLEEPY scales – was performed. The results showed that 42% of the children (n = 164) were diagnosed with obstructive sleep apnea. The six‐item scale (score ≥3) exhibited a sensitivity of 17% and a specificity of 95% for diagnosing obstructive sleep apnea. The eight‐item IF‐SLEEPY scale displayed 82% sensitivity and 28% specificity. The IM‐SLEEPY scale exhibited 79% sensitivity and 32% specificity. In children ≥7 years old, the IF‐SLEEPY (parent‐response) had a sensitivity of 82% and specificity of 28% compared with the child‐response (66% and 37%, respectively). Logistic regression analysis revealed that age (odds ratio = 0.78), IF‐SLEEPY/IM‐SLEEPY score ≥3 (odds ratio = 1.78) and a score ≥2.72 on the six‐item scale (odds ratio = 4.54) were predictors of obstructive sleep apnea. This study suggests that the eight‐item scale is a better screening tool for paediatric obstructive sleep apnea, with a higher sensitivity and simple yes/no responses that are easy to complete and to score.