0796 Implementation of the San Diego Sleep Survey (SDSS) in Children with down Syndrome

Abstract Introduction Obstructive sleep apnea (OSA) is highly prevalent in children with Down syndrome (CWDS). Polysomnography is advised in all CWDS under four years, but at all ages, OSA prevalence remains as high as 75%. Polysomnography in CWDS requires skilled pediatric sleep labs, which are scarce. Implementation of comprehensive sleep questionnaires to identify sleep disorders could lead to earlier recognition and treatment however validated sleep questionnaires in CWDS are not widely available. Methods Caregivers of patients aged 1 to 21 years referred to Rady Children’s Hospital Sleep Center, San Diego, CA, completed the San Diego Sleep Survey (SDSS) via the Epic® EMR system. CWDS were identified using diagnostic codes (ICD-9/10). Additionally, surveys were collected from children without sleep complaints (control) at San Ysidro Children’s Dental Center and Chula Vista Medical Plaza. The SDSS, a 51-item scale, employed a 4-item Likert-type scale (Never, Sometimes, Usually, Do Not Know) for finely graded insights into sleep problems. Five domain scores assessed pediatric sleep problems: insomnia, sleep-disordered breathing (SDB), sleep disorder (e.g., parasomnia), sleep hygiene, and daytime symptoms (DS). A subset also completed the Pediatric Sleep Questionnaire (PSQ) and Children’s Habit Sleep Questionnaire (CSHQ) for comparative purposes. Results 2103 patients completed SDSS (age 8.6±4.8) at the Sleep Center. Of these, 134 CWDS were identified (age 8.1±5.1; 58 females 43%). Compared to controls (n=135, age 9.4±2.4), CWDS had significantly better hygiene scores (8.8±2.0 vs 9.9±2.3, p 0.01), and significantly higher insomnia scores (14.4±3.8 vs 12.9±3.3, p 0.01), SDB scores (17.3±5.2 vs 13.8±6.1, p 0.01) and DS scores (23.6±6.7 vs 19.5±5.9, p 0.01). Sixty-five CWDS completed the PSQ, which identified 27 children (43%) with a positive SDB score (PSQ Total Score ≥8), compared to 104 children (63%) with a positive SDB score on SDSS. Thirty-eight CWDS completed the CSHQ; all had a positive score (CSHQ Total Score ≥41). Conclusion The SDSS is a feasible method for evaluating sleep disturbance in CWDS, recognizing abnormalities in various domains including SDB. Future analyses will compare SDSS to PSQ and CSHQ to assess convergent validity for screening for sleep disorders. Sensitivity and specificity of SDSS to identify OSA compared to polysomnography will be explored. Support (if any)