0780 Pediatric OSA Assessment Tool to Predict Severity of Sleep Disordered Breathing

Abstract Introduction In the general pediatric population, the prevalence of obstructive sleep apnea (OSA) varies between 2% and 5% with several well-established consequences, including learning disability and behavioral difficulties. Resources for evaluation are limited often with long wait times. The STOP-BANG questionnaire has facilitated OSA screening (in adults) and can also predict OSA severity. We developed a pediatric “Severe OSA Score” (SOS), for patients referred for polysomnography to predict severity of the OSA, hence facilitating appropriate triaging of available sleep studies. Methods An 8-item (10-point) SOS questionnaire was developed consisting of: snoring (+1), witnessed apneas (+2), restless sleep (+1), speech/developmental delay (+1), tonsillar hypertrophy (+1), craniofacial abnormality (+2), and body mass index (BMI) percentile 5% or 95% (+1). This was administered prospectively to parents of consecutive patients between 2–12 years, scheduled for a polysomnography (PSG), at the Memorial Hermann Sleep Disorders Center - Texas Medical Center, between December 2022 to February 2023. The obstructive apnea hypopnea index (OAHI) was calculated on PSG (using the American Academy Sleep Medicine scoring manual version 3.0). An OAHI cut-off of 1.5 events/hour was used as diagnostic for OSA. A comparison was made between SOS severity (Group 1: 5 and Group 2: ≤5) and the mean OAHI. Results 45 subjects were included with a M:F gender distribution of 2:1, a mean age of 6.5 years (SD +/- 2.9), and a mean BMI percentile of 74.8 (SD +/- 28.3). All patients were diagnosed with OSA. The mean OAHI was 19.6 events/hour (SD +/- 20.1) with an average SOS score of 4.6 (SD +/- 1.2). When comparing Groups 1 and 2, the difference in the mean OAHI was statistically significant with a mean of OAHI 29.9 versus 14.3 events/hour respectively (p-value of 0.01). Conclusion We were able to prospectively show a strong correlation between a score of 5 on the SOS risk tool and the mean OAHI in this pediatric cohort. This tool hence may be used to identify those children at higher risk for more severe OSA, thereby allowing us to select those patients for more urgent referral when resources are limited. Support (if any)