Clinical Predictors of Pediatric OSAHS

Study Overview
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Brief Summary
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The purpose of this study is to develop adequate and satisfactory tools using reliable clinical and physical factors in predicting pediatric obstructive sleep apnea/hypopnea syndrome (OSAHS) and allow greater access to appropriate therapy in children.

Detailed Description
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The prevalence of OSAHS is estimated to be about 1% to 4% in children, however, it is frequently underdiagnosed because of the difficulties for evaluation.Current diagnostic approaches are based on the patient's history, clinical presentation and physical examination, endoscopy, and radiological imaging examinations, and confirmation is made by the current gold standard of full-night polysomnography (PSG). Previous studies have reported the use of a clinical history, physical examination and questionnaires for predicting pediatric OSAHS but there were lacking of adequate and satisfactory results. Despite the potential diagnostic benefits, PSG for pediatric patients are not routinely used in clinical practice. Therefore, to obtain a reliable, valid, and easily-performed diagnostic or screening tool for the clinical assessment of pediatric OSAHS is essential for the cost-effective care of these patients.

Official Title
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Clinical Predictors of Pediatric Obstructive Sleep Apnea/Hypopnea Syndrome

Conditions
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Pediatric Sleep Apnea

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: children (younger than 18 years old and older than 2 years old) with symptoms of snoring and then were confirmed to having obstructive sleep apnea/hypopnea syndrome by a comprehensive polysomnography Exclusion Criteria: patients with substance abuse problems or the long-term usage of medications known to affect sleep, craniofacial abnormalities or neuromuscular disorders, Down syndrome, cerebral palsy, mucopolysaccharidoses, Prader-Willi syndrome, history of psychosis, central sleep apnea syndrome, or previous airway surgery including tonsillectomy and/or adenoidectomy were excluded from the study.

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| pediatric sleep apnea<br>The children were confirmed to have OSAHS by comprehensive polysomnography (PSG). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical predictors for apnea/hypopnea index (AHI) | When all variables were analyzed individually with the AHI, Spearman rank correlation analysis was used to explore the relationships between clinical predictor variables and AHI.Significant variables were entered into stepwise multiple linear regression analysis to identify independent predictors for pediatric OSAHS and to develop a predictive equation for AHI values. | up to 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anthropometric measurements: body mass index z-score (BMI z-score) | BMI z-score: a measure of relative weight adjusted for the child's age and gender, and calculated by dividing the difference between the measured value and the mean by the standard deviation. | up to 4 months | 
| Anthropometric measurements: tonsil size grading | Tonsil size grading: 0, surgically removed tonsils; 1, tonsils hidden within the pillars; 2, tonsils extending to the pillars; 3, tonsils were beyond the pillars but not to the midline; and 4, tonsils extended to the midline. | up to 4 months | 
| Anthropometric measurements: modified Mallampati grade (aka updated Friedman's tongue position | updated Friedman's tongue position: I: visualization of the entire uvula and tonsils/pillars.; IIa: visualization of most of the uvula, but the tonsils/pillars are absent.; IIb: visualization of the entire soft plate to the base of the uvula.; III: visualization of some of the soft palate, but the distal structures are absent.; IV: visualization of the hard palate only. | up to 4 months | 
| Anthropometric measurements: uvular length | uvular length in centimeter | up to 4 months | 
| Snoring visual analogue scale (Snoring VAS) | Snoring VAS (Units on a Scale): 0-10, 0 = no snoring noise and 10 = the loudest sound imaginable | up to 4 months | 
| Apnea/hypopnea index (AHI) | AHI: total number of apneas and hypopneas per hour of electroencephalographic sleep. | up to 4 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pediatric obstructive sleep apnea/hypopnea syndrome, Polysomnography