Pediatric Obstructive Sleep Apnea: Proposed Abbreviated Screening Questionnaire

Objective: The aim was to determine the predictive utility of a proposed 5-item Pediatric Obstructive Sleep Apnea (POSA) screening questionnaire in establishing appropriate referrals and possible Obstructive Sleep Apnea (OSA) diagnosis. Hypothesis: H0: Positive answers to UIC abbreviated screening questionnaire are associated with appropriate referrals leading to OSA diagnosis. H1: There is no significant correlation between positive answers to UIC abbreviated screening questionnaire and OSA diagnosis from referrals. Methods: In this retrospective cohort study, we abstracted data from the electronic health records for children seen at UIC Pediatric Dentistry Clinic. The study included patients ages 0 months – 12 years who were seen during 09/02/2020 – 05/20/2022 and had a completed Pediatrics Exam form. Data included information from the OSA questionnaire, medical alerts, medical history form, chart notes, consultations and demographic information. Data analysis included bivariate analysis and Mantel-Haenszel chi-squared test. Based on bivariate analysis, we created an OSA Index and measured its sensitivity and specificity for predicting OSA diagnosis, using weighted based on bivariate strength of association. Results: A positive (yes) answer to any item in the OSA questionnaire was significantly associated with referrals for OSA evaluation. Individuals who answered positively on snoring ≥2 times/ week, trouble breathing, stop breathing, or mouth breathing during sleep were significantly more likely to be diagnosed with OSA. Sleepiness during the day was not significantly associated with OSA diagnosis. An overall score of ≥3 had sensitivity of 68.2% and specificity of 94.0%. Conclusions: Our screening questionnaire is effective in identifying youth at high risk for OSA. When used with our proposed weighting scale, this questionnaire shows moderate-to-high sensitivity and specificity, as well as was validated in a large sample population. Implementation of this questionnaire would encourage large scale screening and pertinent referrals in a busy clinical setting.