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Clinical screening of school children for polysomnography to detect sleep-disordered breathing--the Tucson Children's Assessment of Sleep Apnea study (TuCASA).
J Clin Sleep Med. 2005 Jul 15; 1(3):247-54.JC

Abstract

STUDY OBJECTIVES

This report describes the associations, specificities, sensitivities, and positive likelihood ratios of clinical symptoms to a finding of sleep-disordered breathing (SDB) on polysomnography in children.

METHODS

Four hundred eighty unattended home polysomnograms were completed in a community-based cohort of children 6 to 11 years of age (50% boys, 42.3% Hispanic, and 52.9% between the ages of 6 and 8 years). SDB was present if the child had a respiratory disturbance index of > or = 1 event per hour.

MEASUREMENTS AND RESULTS

Boys were twice as likely as girls to have SDB (p < .01); however, witnessed apnea, ethnicity, age, obesity, and airway size (based on clinical evaluation) were not significantly different between those with SDB and without SDB. The sensitivity of any individual or combined clinical symptoms was poor, with male sex (60%) and snoring (29.5%) having the greatest proportion of SDB children. However, high specificities for snoring (89.5%), excessive daytime sleepiness (86.3%), and learning problems (95.9%) were noted. Combinations of symptoms such as snoring+male sex (95.1%), snoring+excessive daytime sleepiness (97.0%), and snoring+learning problems (98.9%) had specificities approaching 1. Positive likelihood ratios for snoring (2.8), learning (2.8), and symptoms combined with snoring such as snoring+male sex (3.9), snoring+learning problems (4.0), and snoring+excessive daytime sleepiness (2.9) were observed.

CONCLUSIONS

Snoring, excessive daytime sleepiness, and learning problems are each highly specific, but not sensitive, for SDB in 6- to 11-year old children. However, specificities and positive likelihood ratios for the combination of some of these symptoms is sufficiently high to suggest that some children may not require a polysomnogram for the diagnosis of SDB.

Authors+Show Affiliations

University of Arizona College of Medicine, Arizona Respiratory Center, Box 245030, 1501 N. Campbell, Room 2329, Tucson, AZ 85724, USA. jamieg@arc.arizona.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16429591

Citation

Goodwin, James L., et al. "Clinical Screening of School Children for Polysomnography to Detect Sleep-disordered Breathing--the Tucson Children's Assessment of Sleep Apnea Study (TuCASA)." Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, vol. 1, no. 3, 2005, pp. 247-54.
Goodwin JL, Kaemingk KL, Mulvaney SA, et al. Clinical screening of school children for polysomnography to detect sleep-disordered breathing--the Tucson Children's Assessment of Sleep Apnea study (TuCASA). J Clin Sleep Med. 2005;1(3):247-54.
Goodwin, J. L., Kaemingk, K. L., Mulvaney, S. A., Morgan, W. J., & Quan, S. F. (2005). Clinical screening of school children for polysomnography to detect sleep-disordered breathing--the Tucson Children's Assessment of Sleep Apnea study (TuCASA). Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 1(3), 247-54.
Goodwin JL, et al. Clinical Screening of School Children for Polysomnography to Detect Sleep-disordered Breathing--the Tucson Children's Assessment of Sleep Apnea Study (TuCASA). J Clin Sleep Med. 2005 Jul 15;1(3):247-54. PubMed PMID: 16429591.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical screening of school children for polysomnography to detect sleep-disordered breathing--the Tucson Children's Assessment of Sleep Apnea study (TuCASA). AU - Goodwin,James L, AU - Kaemingk,Kris L, AU - Mulvaney,Shelagh A, AU - Morgan,Wayne J, AU - Quan,Stuart F, PY - 2006/1/24/pubmed PY - 2007/7/27/medline PY - 2006/1/24/entrez SP - 247 EP - 54 JF - Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine JO - J Clin Sleep Med VL - 1 IS - 3 N2 - STUDY OBJECTIVES: This report describes the associations, specificities, sensitivities, and positive likelihood ratios of clinical symptoms to a finding of sleep-disordered breathing (SDB) on polysomnography in children. METHODS: Four hundred eighty unattended home polysomnograms were completed in a community-based cohort of children 6 to 11 years of age (50% boys, 42.3% Hispanic, and 52.9% between the ages of 6 and 8 years). SDB was present if the child had a respiratory disturbance index of > or = 1 event per hour. MEASUREMENTS AND RESULTS: Boys were twice as likely as girls to have SDB (p < .01); however, witnessed apnea, ethnicity, age, obesity, and airway size (based on clinical evaluation) were not significantly different between those with SDB and without SDB. The sensitivity of any individual or combined clinical symptoms was poor, with male sex (60%) and snoring (29.5%) having the greatest proportion of SDB children. However, high specificities for snoring (89.5%), excessive daytime sleepiness (86.3%), and learning problems (95.9%) were noted. Combinations of symptoms such as snoring+male sex (95.1%), snoring+excessive daytime sleepiness (97.0%), and snoring+learning problems (98.9%) had specificities approaching 1. Positive likelihood ratios for snoring (2.8), learning (2.8), and symptoms combined with snoring such as snoring+male sex (3.9), snoring+learning problems (4.0), and snoring+excessive daytime sleepiness (2.9) were observed. CONCLUSIONS: Snoring, excessive daytime sleepiness, and learning problems are each highly specific, but not sensitive, for SDB in 6- to 11-year old children. However, specificities and positive likelihood ratios for the combination of some of these symptoms is sufficiently high to suggest that some children may not require a polysomnogram for the diagnosis of SDB. SN - 1550-9389 UR - https://www.unboundmedicine.com/medline/citation/16429591/Clinical_screening_of_school_children_for_polysomnography_to_detect_sleep_disordered_breathing__the_Tucson_Children's_Assessment_of_Sleep_Apnea_study__TuCASA__ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/16429591/ DB - PRIME DP - Unbound Medicine ER -