Comparison of assessment tools content and psychometric properties in children with obstructive sleep apnea: systematic review of the literature

Due to the increasing health problems in pediatric obstructive sleep apnea (OSA) patients, including hypertension, cardiovascular diseases, metabolic disorders, obesity, neuropsychiatric and developmental issues, it is essential toinvestigate the presence of childhood OSA by using specific and validated assessment tool to diagnose OSA and to assess childrens needs. The purpose of this study was to determine most commonly used tools for assessing OSA in children, to compare their content using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), and to compare their psychometric characteristics. Most commonly used assessment tools for pediatric OSA were identified, including Polysomnography, Pediatric Sleep Questionnaire, Epworth Sleepiness Scale for Children and Adolescents, Obstructive Sleep Apnea 18 and the Pediatric Quality of Life Inventory, and linked to the ICF-CY according to the ICF linking rules. The analysis of the psychometric properties of these instruments were observed. A total of 77 studies were identified, showing 26 tools for assessing OSA in the pediatric population. In order to identify meaningful concepts, the most frequently used assessment tools were linked to 65 ICF-CY categories. The predominance of linked concepts was observed in the PSQ. The predominance in categories of the component body functions in PSQ and OSA-18 was equal. Linking to one body structure was performed with PSG and OSA-18. Linking to categories of activities and participation was done for all instruments. Categories of environmental factors were not linked only with PSG. All commonly used assessment tools have been shown to be reliable and valid, while responsiveness to change has only been demonstrated in OSA-18. PSQ is reliable and valid tool for assessing sleep-disordered breathing, snoring, drowsiness and behavioral disorders in children aged 2 to 18 years to identify sleep-disordered breathing, including OSA, when polysomnography isn’t possible.