Is the OSA-18 predictive of obstructive sleep apnea: Comparison to polysomnography

• Published in: The Laryngoscope 2015-06, Vol.125 (6), p.1491-1495
• Main Authors: Ishman, Stacey L., Yang, Christina J., Cohen, Aliza P., Benke, James R., Meinzen-Derr, Jareen K., Anderson, Rebecca M., Madden, Marie E., Tabangin, Meredith E.
• Format: Article
• Language: English
• Subjects: Age; Child; Child, Preschool; Cross-Sectional Studies; Female; Health Status Indicators; Humans; Logistic Models; Male; obstructive sleep apnea; OSA-18; Polysomnography; Quality of Life; ROC Curve; Sensitivity and Specificity; Sleep apnea; Sleep disorders
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.25098

Objectives/Hypothesis To examine the ability of the OSA−18 to predict Obstructive Sleep Apnea (OSA) in a racially diverse population when compared to overnight polysomnography (PSG). Study Design Cross‐sectional retrospective. Methods Children 2 to 12 years of age diagnosed with OSA who were treated at a tertiary care institution between 2008 and 2013 and had complete PSG and OSA‐18 data were included. We performed logistic regression with OSA as the dependent variable and the OSA‐18 total symptom score (TSS), age, gender, race, asthma, and body mass index (BMI) as independent variables. Results Seventy‐nine children (32 females) were included (mean age 5.2 ± 2.4 years). The positive predictive value (PPV) was greater than 90 for an obstructive apnea–hypopnea index (oAHI) ≥ 1. The PPV and specificity were higher for white than for nonwhite children; however, sensitivity and negative predictive value (NPV) of OSA‐18 TSS were low for mild, moderate, and severe OSA regardless of race. Age, race, and BMI were not significantly associated with oAHI. Conclusions This study, conducted in a racially diverse cohort, examined the ability of the OSA‐18 to predict OSA when compared to PSG—the gold standard—and found that sensitivity and NPV were extremely low for both white and nonwhite children. This suggests that the OSA‐18 is not sufficiently sensitive to detect OSA nor sufficiently specific to determine the absence of OSA. The OSA‐18 should be used as a quality‐of‐life indicator and is not a reliable substitute for PSG. Level of Evidence 4. Laryngoscope, 125:1491–1495, 2015