Comparison of Epworth Sleepiness and OSA-18 Scores With Pediatric Polysomnography

Tuesday, October 3, 2023

10:03 AM - 10:09 AM East Coast USA Time

Location: 103A

Presenting Author(s)

Beatrice R. Bacon, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences
Basom, NY, United States

Co-Author(s)

Erin G. Gould, MD

Resident
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Kenmore, NY, United States
RA

Riad Al Sabbagh, DO

DO
Duke University
Durham, NC, United States
AH

Amanda Hassinger, MS MD

Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, USA
Mattie R. Rosi-Schumacher, MD

Resident Physician
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, NY, United States

Senior Author(s)

Michele M. Carr, DDS MD PhD

Professor
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Williamsville, NY, United States

Disclosure(s):

Mattie R. Rosi-Schumacher, MD: No relevant relationships to disclose.

Michele M. Carr, DDS MD PhD: No relevant relationships to disclose.

Introduction: The gold standard for obstructive sleep apnea (OSA) diagnosis in children is in-lab polysomnography (PSG). The Epworth Sleepiness Scale (ESS) and OSA-18 Scale describe patient symptoms and are widely used. Our goal is to determine if there is a correlation between ESS scores, OSA-18 scores, and PSG outcomes in children.

Methods: Charts of consecutive children presenting at a pediatric otolaryngology clinic between July 2021 and September 2022 were reviewed. Demographics, BMI, Z-score, ESS score, OSA-18 score, PSG results (Apnea Hypopnea Index (AHI), obstructive AHI (oAHI), oxygen saturation nadir), and OSA severity were included.

Results: 241 children were included, 100 (41.5%) girls and 141 (58.5%) boys. The median patient age was 6.6 (IQR1-3, 3.6-10.5) years. Mean BMI z-score was 1.1 (95% CI 0.5-1.8). Median ESS score was 5 (IQR1-3, 3-10), median OSA-18 score was 53 (IQR1-3, 42-68.5). Mean AHI was 10.4 (95% CI 8.7-12.1), oAHI was 9.5 (95% CI 7.7-11.4), and oxygen saturation nadir was 89.7% (95% CI 88.5-90.9%). 42 (17.4%) had mild OSA, 129 (53.5%) had moderate OSA and 66 (27.4%) had severe OSA. ESS correlated weakly with age (r=0.202, p=.002), AHI (r=0.179, p=.005), oAHI (r=0.191, p=.006), and oxygen saturation nadir (r=-0.206, p=.001). OSA-18 only correlated with age (r=-0.318, p=.01), not with any PSG findings. After adjusting for age and BMI, neither ESS nor OSA-18 scores significantly correlated with AHI.

Conclusions: Correlations between ESS scores in children with OSA are likely related to age and BMI. As neither score was predictive of PSG results, use of these scales alone may not accurately predict sleep apnea.