Comparison of Epworth Sleepiness Scale and OSA‐18 Scores With Polysomnography in Children

Abstract Objective Our goal is to determine if there is a correlation between Modified Epworth Sleepiness Scale (M‐ESS) scores, obstructive sleep apnea (OSA)‐18 scores, and polysomnography (PSG) outcomes in children. Study Design Retrospective chart review. Setting Pediatric otolaryngology clinic. Methods Charts of consecutive children presenting from July 2021 to July 2023 were reviewed. Demographics, body mass index (BMI), BMI Z score, M‐ESS score, OSA‐18 score, PSG results, and sleep apnea severity were included. One‐way analysis of variance and Pearson/Spearman correlation coefficients were calculated. Results Three hundred sixty‐seven children were included, 162 (44.1%) girls and 205 (55.9%) boys. Mean patient age was 7.8 (95% confidence interval CI: 7.3‐8.3) years. M‐ESS score was 6.3 (n = 348, 95% CI: 5.8‐6.8), mean OSA‐18 score was 56.2 (n = 129, 95% CI: 53.0‐59.4). Mean apnea‐hypopnea index (AHI) was 10.1 (95% CI: 8.7‐11.4) events/h, obstructive AHI 9.3 (95% CI: 8.0‐12.7) events/h, respiratory distress index 14.6 (95% CI: 8.4‐20.8) events/h, and oxygen saturation nadir 89.8% (95% CI: 89.1‐90.4). Sixty‐two children (17.2%) had mild, 192 (53.5%) moderate, and 105 (29.2%) severe sleep apnea. M‐ESS score correlated weakly to AHI ( r = .19, P = <.001), and OSA‐18 score to oxygen saturation nadir ( r = −.16, P = .002). After logistic regression adjusted for age and BMI, neither clinical scores were independently associated with AHI. Conclusion M‐ESS and OSA‐18 scores have a weak correlation with OSA severity in children. More reliable, age‐appropriate screening tools are needed in pediatric sleep apnea.