The reliability and validity of the Thai version Epworth sleepiness scale for children and adolescents (ESS-CHAD) in pediatric obstructive sleep apnea
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Abstract
Background : OSA, a condition that the upper airway collapsed momentarily while sleeping, consist of many symptoms, e.g. snoring, excessive daytime sleepiness. Because of high global prevalence, many questionnaires were developed. Epworth sleepiness scale was used for screening in adults. Subsequently, ESS-CHAD was created.
Objective : The objectives of this study are to evaluate the reliability and validity between ESS-CHAD and pediatric OSA, and to investigate the relationship between ESS-CHAD and severity of OSA.
Methods : 41 subjects (31 males and 10 females) were recruited and investigated for the reliability.. To check the discriminant validity of the ESS-CHAD, we included 26 OSA patients, 9 mild OSA, 10 moderate OSA and 7 severe OSA patients,confirmed by polysomnography.
Results : The internal consistency demonstrated by Cronbach’s alpha coefficients was 0.836. The test–retest reliability demonstrated by intra-class correlation coefficients of 0.982. There were statistically significant difference between the ESS-CHAD scores in mild OSA (3.33± 1.87) and severe OSA patients (9.85± 5.43) (p < 0.05), and between ESS-CHAD scores and Pediatric Sleep Questionnairre (p < 0.05). It had the highest sensitivity and specificity of 70.59% and 77.78% with a cut-off score ³ 5. There was no correlation between ESS-CHAD and polysomnogram parameters.
Conclusions : Our first Thai version of the ESS-CHAD showed an excellent internal consistency and test–retest reliability. It is able to discriminate between mild OSA patients and severe OSA patients with a cut-off value ³ 5; however, it does not have a relationship with the polysomnogram parameters.
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