Can parents predict the severity of childhood obstructive sleep apnoea?

Objective: To determine whether parents' observations can be used to prediet the severity of the obstructive sleep apnoea syndrome (OSAS) in children. Study design: Sixty-five children with OSAS diagnosed by overnight polysomnography were consecutively recruited and classified as having severe or non-severe OSAS according to the obstructive apnoea index (OAI) and the oxygen saturation measured by pulse oximetry (SPO2) nadir. Parents were asked to complete a questionnaire about the child's breathing difficulties at night. Results: Twenty-eight patients were classified as severe OSAS and 37 as non-severe OSAS. There were no differences between the two groups with respect to age, sex or body mass index. Male to female ratio was 5:1. Parents of children with severe OSAS more frequently reported observed cyanosis (35 vs 8%; p = 0.02); obstructive apnoea (60 vs 35%; p = 0.04); snoring extremely loudly (52 vs 22%; p = 0.01); shaking the child (64 vs 35%; p = 0.02); watching the child during sleep and being afraid of apnoea (85 vs 60%; p = 0.03). However, neither any single nor combinations of observations showed high values for both sensitivity and specificity. Conclusions: Although some parents' observations are more frequently reported in children with severe OSAS, neither any single nor combinations of observations accurately predict the severity of OSAS. polysomnography is still needed to determine the severity of obstruction.