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Congruence between polysomnography obstructive sleep apnea and the pediatric sleep questionnaire: fatigue and health-related quality of life in juvenile idiopathic arthritis

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Abstract

Purpose

To examine the congruence between polysomnography obstructive apnea hypopnea index (OAHI) and parent-reported obstructive sleep apnea (OSA) symptoms in 6- to 11-year-old children with juvenile idiopathic arthritis (JIA) and controls; and to compare fatigue and quality of life in JIA and control children based on OAHI and OSA symptoms.

Methods

Sixty-eight children with JIA and 75 controls and a parent participated. Children underwent one night of polysomnography in a sleep laboratory. Parents completed the sleep-related breathing disorders scale—pediatric sleep questionnaire (PSQ), and both children and parents completed the Pediatric Quality of Life Generic Core Scale and the Multidimensional Fatigue Scale.

Results

In JIA, 86% who met the OAHI clinical criteria for OSA (≥1.5) were above the PSQ OSA symptom cut-off score with a sensitivity of 0.86 and a specificity of 0.28. In the control group, 63% who met the OAHI clinical criteria for OSA were above the PSQ OSA symptom cut-off score, with a sensitivity of 0.63 and a specificity of 0.42. All children above both the clinical criteria for OAHI and OSA symptom cut-off score had the most impaired quality of life and greater fatigue compared to those below both the clinical criteria for OAHI and the OSA symptom cut-off score.

Conclusion

Children who meet clinical criteria for OSA and also scored high on a parent-reported screening tool for OSA symptoms had the most impaired quality of life and more fatigue. The PSQ has potential to identify children at risk for OSA.

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Acknowledgements

The authors thank the children and families who helped with this research. We thank Ching Hung and Lucas Reichley, Research Coordinator in the Rheumatology Clinic for recruiting the participants. We thank Ernie Tolentino, Laboratory Manager, and the sleep laboratory staff, James Rothermel, Alexandra Lexie Miller, Casey Guilland, Philip Celerian, Alexa Celerian, Megha Santhosh, Susie Chen, Anna Duong, Willada Locha, Deenpret Dhaliwal for data collection and processing.

Author’s contributions

TMW had full access to all the data in the study and takes responsibility for the integrity of the data, and TMW and KCP take responsibility for the accuracy of the data analysis. All authors made substantial contributions to the study and this manuscript. None were compensated for the manuscript preparation.

Funding

The study was supported by the National Institute of Nursing Research, NIH, (# RO1NR012734) and the Center for Research on Management of Sleep Disturbances, National Institute of Nursing Research (# P30NR011400). The funding sources had no role in the designs and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, and approval of the manuscript, and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Family and Child Nursing, School of Nursing, University of Washington, Box 357262, Seattle, WA, 98195-7266, USA

    Teresa M. Ward, Carol A. Landis & Kenneth C. Pike

  2. Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA, USA

    Maida Lynn Chen

  3. Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Dean W. Beebe

  4. Division of Rheumatology, Department of Pediatrics, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA, USA

    Sarah Ringold & Carol A. Wallace

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  1. Teresa M. Ward
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Correspondence to Teresa M. Ward.

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Ward, T.M., Chen, M.L., Landis, C.A. et al. Congruence between polysomnography obstructive sleep apnea and the pediatric sleep questionnaire: fatigue and health-related quality of life in juvenile idiopathic arthritis. Qual Life Res 26, 779–788 (2017). https://doi.org/10.1007/s11136-016-1475-3

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