Performance of Children's Sleep Disturbance Scale for the Diagnosis of Obstructive Sleep Apnea in Children with Cleft Lip and Palate

ObjectiveTo evaluate associations between Sleep Disturbance Scale for Children (SDSC) findings and polysomnographic parameters and the diagnostic performance of its Sleep Breathing Disorders (SBD) and Excessive Daytime Sleepiness (EDS) subscales for identifying obstructive sleep apnea (OSA) in children with non-syndromic cleft conditions.DesignProspective, analytical, cross-sectional diagnostic study.SettingTertiary craniofacial referral center.Patients, ParticipantsChildren aged 3 years 8 months to 13 years with non-syndromic cleft lip and palate or isolated cleft palate. Forty-two underwent polysomnography; 38 had valid recordings and 37 had complete paired questionnaire and polysomnographic data.Main Outcome Measure(s)Associations between SDSC scores and polysomnographic parameters; sensitivity, specificity, predictive values, and accuracy of the SBD and EDS subscales for identifying PSG-defined OSA (apnea-hypopnea index ≥1 event/h).ResultsOSA was identified in 27 of 38 participants (71.1%) with valid recordings and was predominantly mild. SDSC total and subscale scores were not significantly correlated with polysomnographic parameters. The SBD subscale had sensitivity of 38.5% and specificity of 72.7%; the EDS subscale had sensitivity of 23.1% and specificity of 54.5%.ConclusionsSDSC findings showed limited agreement with polysomnography, and the SBD and EDS subscales could not reliably identify or exclude OSA. The SDSC may complement clinical assessment by characterizing caregiver-reported symptoms, but polysomnography remains necessary for objective diagnosis and severity classification.