Performance characteristics of the French version of the severity hierarchy score for paediatric sleep apnoea screening in clinical settings

•Sleep studies (NPSG) are required for diagnosis of obstructive sleep apnoea syndrome in children.•NPSG are not always widely available.•Development of questionnaires that improve NPSG selection is needed.•A six-item questionnaire revealed favourable performance in French children.

BackgroundPaediatric obstructive sleep apnoea syndrome (OSAS) is a highly prevalent condition carrying increased risk for impaired cognitive and cardiovascular function. The standard diagnosis consists of full-night polysomnography (PSG), but limited access to PSG leads to substantial under-diagnosis. The use of a validated and simple diagnostic screening tool to predict OSAS could prioritise night sleep recordings in children at risk of OSAS, and help in clinical decision-making.ObjectiveThis study aimed to prospectively assess the performance of the French version of the severity hierarchy score (SHS) in paediatric OSAS. This score consists of a discriminative subset of six respiratory items, and has already been validated in English for screening OSAS in the general paediatric population.MethodsA total of 96 children (mean age 7.1 ± 2.4 years; BMI z-score: −0.03 ± 1.50) were recruited; they had been were referred to two academic sleep centres in France for the putative diagnosis of sleep-disordered breathing. The parents completed the SHS questionnaire prior to PSG. Sensitivity and specificity of the SHS for detecting moderate OSAS, defined by an apnoea-hypopnoea index (AHI) of ≥5/hours of total sleep time (TST), were assessed, and ROC analysis was performed.ResultsAn SHS score of >2.75 exhibited an 82% sensitivity, 81% specificity, and 92% negative predictive value for detecting an AHI of ≥5/hour TST in the cohort.ConclusionThe French version of the SHS emerged as favourably suited for the screening for OSAS in children.