The Valence Sleep Score - A Simple Clinical Tool for the Diagnosis of Obstructive Sleep Apnea in Children - Abstract
Objectives: Obstructive Sleep Apnea (OSA) is the ultimate stage of sleep disorders breathing. It concerns between 1.2 and 5.2% of the pediatric population, and its prevalence is probably underestimated. Polysomnography is the gold standard for diagnosis but it is an expensive procedure and the difficulty to access makes it necessary to establish clinical score for early diagnosis and treatment. We create a simple clinical tool, compared to home sleep apnea testing (HSAT), including patient history and physical examination, to diagnose OSA in children.
Methods: Prospective, observational multi-center study that included children who underwent clinical examination and HSAT. OSA was identified by respiratory disturbance indices commonly applied in clinical practice. A ROC curve was calculated for each sign and a combined score was calculated with the most important clinical symptoms.
Results: A total of 119 children were included, 108 were classified as having OSA, 11 as primary snorers. The Valence sleep score (VSS) is a combination of signs (scored 1 if the sign is present and 0 if it is not) and the Friedman score: Family history of OSA + Nocturnal enuresis + Dental Malocclusion + Narrow palate + Friedman Score. For a VSS ? 5, specificity was 81.8%, positive predictive value was 97%, positive likelihood ratio was 3.42, and negative predictive value was 0.46.
Conclusion: VSS can be used to diagnose OSA in children to enable those with a score ? 5 to receive early treatment.