Pediatric sleep questionnaire: prediction of sleep apnea and outcomes

Arch Otolaryngol Head Neck Surg. 2007 Mar;133(3):216-22. doi: 10.1001/archotol.133.3.216.


Objectives: To further validate a questionnaire about symptoms of childhood obstructive sleep apnea (OSA) and to compare the questionnaire with polysomnography in their ability to predict outcomes of adenotonsillectomy.

Design: Retrospective analysis of data from a longitudinal study.

Setting: University-based sleep disorders laboratory.

Participants: The Washtenaw County Adenotonsillectomy Cohort, comprising 105 children aged 5.0 to 12.9 years at entry. Intervention Parents completed the 22-item Sleep-Related Breathing Disorder (SRBD) scale of the Pediatric Sleep Questionnaire, and children underwent polysomnography before and 1 year after clinically indicated adenotonsillectomy (n = 78, usually for suspected OSA) or unrelated surgical care (n = 27).

Main outcome measures: Findings from commonly used hyperactivity ratings, attention tests, and sleepiness tests.

Results: At baseline, a high SRBD scale score (1 SD above the mean) predicted an approximately 3-fold increased risk of OSA on polysomnography (odds ratio, 2.80; 95% confidence interval, 1.68-4.68). One year later, OSA and symptoms had largely resolved, but a high SRBD score still predicted an approximately 2-fold increased risk of residual OSA on polysomnography (odds ratio, 1.89; 95% confidence interval, 1.13-3.18). Compared with several standard polysomnographic measures of OSA, the baseline SRBD scale better predicted initial hyperactivity ratings and 1-year improvement, similarly predicted sleepiness and its improvement, and similarly failed to predict attention deficit or its improvement.

Conclusions: The SRBD scale predicts polysomnographic results to an extent useful for research but not reliable enough for most individual patients. However, the SRBD scale may predict OSA-related neurobehavioral morbidity and its response to adenotonsillectomy as well or better than does polysomnography.

Publication types

  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Adenoidectomy*
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Child
  • Child Behavior / physiology
  • Child, Preschool
  • Female
  • Humans
  • Logistic Models
  • Male
  • Parents
  • Polysomnography*
  • Predictive Value of Tests
  • Retrospective Studies
  • Sleep
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / surgery
  • Surveys and Questionnaires*
  • Tonsillectomy*