关键词: 睡眠呼吸暂停综合征, 儿童睡眠问卷, 效价分析

Abstract: Objective Obstructive sleep apnea syndrome (OSAS) in children is a common respiratory disease that affects growth and development in children. Currently, there is a lack of fast and efficient assessment methods. In order to detect OSAS in children at an early stage, this study aims to explore the application and valence evaluation of the Pediatric Sleep Questionnaire (PSQ) in the latest diagnostic criteria for OSAS in children. 
Methods Children with snoring and mouth breathing during sleep who were aged 3-14 years presented to the First Affiliated Hospital of Guangzhou Medical University for overnight polysomnography (PSG). They were divided into OSAS group (n=147), and the control group (without OSAS after PSG, n=67). The valence of PSG in the latest diagnostic criteria for pediatric OSAS was analyzed by calculating standardized load factors and logistic regression analysis.  
Results Amos model was used to analyze the exploratory factors on 21 items and indicated KOM=0.703, and Barlett′s test of sphericity P＜0.001. Comparing the respiratory items of questionnaires in the two groups, there was a significant difference between the OSAS group and the control group with respect to A3 (P＜0.001), A4 (P＜0.001), A5 (P＜0.001) and A6 (P＜0.001), while there was no significant difference in A24, A25 and B7. This suggested that children in the OSAS group were mainly characterized by snoring during sleep, with less mouth breathing, dry mouth, and dizziness, while B4 was significantly different (P＜0.004), indicating that children in the OSAS group were more prone to daytime drowsiness or a tendency to sleep excessively. In terms of behavior items, there were significant differences between the OSAS group and the control group with respect to C3 (P＜0.001), C5 (P＜0.001), C8 (P＜0.001), and C10 (P＜0.001), indicating that OSAS children had significant attention deficit. The logistic regression analysis showed that the overall reliability Cronbach coefficient was 0.772, and the internal correlation coefficient was 0.754. Adverse outcome of OSAS was strongly positively correlated with A2, A3, A4, A5, A7, A25, B4, C10, and A32, which indicated the respiratory related questionnaire playing crucial roles in OSAS outcome. The critical value of PSQ in the latest diagnostic criteria for OSAS was 4.5, with a sensitivity of 82.3%, aspecificity of 85.1%, positive predictive value of 0.924, and negative predictive value of 0.687. 
Conclusion This study shows that the simplified Chinese version of PSQ can be a primary tool for screening OSAS patients in clincal practice. 

Key words: sleep apnea syndromes, pediatric sleep questionnaire, valence analysis