Automated screening systems can be used to support primary care physicians (PCPs) in identifying children at risk for obstructive sleep apnea (OSA), according to a study presented at the 2018 SLEEP meeting held June 2-6 in Baltimore, Maryland.
Rates of screening and referral in primary care have been found to be low in children with OSA. In children with snoring and one other sign or symptom of OSA, guidelines recommend referral for polysomnogram, to an otolaryngologist, etc. Since specific screening strategies have not been identified and the prevalence of children who meet the criteria for OSA referral had not been documented, the aim of this study was to describe an automated OSA screening system and report the prevalence of children with snoring plus one additional OSA symptom.
In this study, a computer decision support system (Child Health Improvement through Computer Automation) was employed to screen snoring children between the age of 2 and 11 in 2 primary care clinics from February 2017 to December 2017. Parents were asked to report symptoms of apnea, morning headache, sleepiness, nighttime breathing trouble, waking with a snort and enuresis, with other risk factors (overweight and attention deficit hyperactivity disorder [ADHD]) pulled from the electronic health record.
There were 348 (18.5%) snoring children identified from the 1865 parents who responded to a single question about snoring. OSA symptoms in snoring children ranged from 6% for apnea to 45% for overweight. Of the snoring children, 77.9% met criteria for referral with at least one additional OSA symptom, representing 13.5% of all children screened.
The investigators concluded: “automated screening systems can be implemented to support PCPs [primary care physicians] in identifying children at-risk for OSA.” Further evaluation by the sleep medicine field is needed.
Honaker SM, Downs SM. Automated universal OSA screening in pediatric primary care. Presented at: SLEEP 2018; June 2-6, 2018; Baltimore, MD. Abstract 0744.