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The Validation and Reliability of Chinese Version of the Pediatric Sleep Questionnaire for Patients with Sleep Breathing Problem

Chih-Huan Wang, Chien-Ming Yang, Yu-Shu Huang

Objective: The Pediatric Sleep Questionnaire (PSQ) has been shown to be a
validated tool with high sensitivity and specifi city for screening sleep-disordered
breathing in children and adolescents. The objective of this study was to translate
the English version into Chinese version (CPSQ) and to determine the psychometric
measurements of CPSQ in pediatric patients with sleep-disorder breathing
(SDB). Methods: The CPSQ was translated through forward-backward translation
method by one expert of sleep medicine and two bilingual individuals. To
validate the reliability, we identifi ed 127 children and adolescents (aged 6 to 15
years, mean age = 8.92 ± 2.05 years) suffering from obstructive sleep apnea (OSA)
with polysomnography (PSG). Those study subjects completed the CPSQ during
initial diagnosis and at a follow-up 4 weeks later. We also recruited 46 age-and
sex-matched controls from the general community. They were also assessed using
the same tool. Results: Internal consistencies were within acceptable range for all
subscales, and the Cronbach’s α of “snoring,” “mouth breathing,” “daytime sleepiness,”
“behavior scale (hyperactivity/inattention),” and “sleep-related breathing
problem(SRBD)” were 0.815, 0.730, 0.62, 0.852 and 0.826, respectively. Spearman’s
correlation coeffi cients analysis comparing the two separate administrations
with a four-week interval yielded moderately high correlations for all the subscales
(snoring: 0.862, mouth breathing: 0.742, SRBD: 0.786, daytime sleepiness: 0.760,
behavior scale: 0.868, and other symptoms: 0.685), suggesting that the CPSQ is a
reliable and valid instrument for evaluating sleep-related symptoms in children
and adolescents with sleep disorders. In the retriever operating characteristics
(ROC) analysis, we found that “snoring” and “SRBD” subscales had high sensitivity
in identifying SDB , with values of 0.832 (95% CI: 0.682-0.988) , and 0.882
(95% CI: 0.757-1.000). The “sleepiness” subscale had moderated sensitivity with
values of 0.753 (95% CI: 0.583-0.923) for areas under the ROC curve. Conclusion:
The CPSQ was found to have acceptable psychometric properties. It can be
a useful tool for screening SDB in children and adolescents in clinical settings in
Taiwan.
Key Word Chinese Pediatric Sleep Questionnaire, daytime sleepiness, children and adolescents, sleep-disordered breathing
Editorial Committe, Taiwanese Journal of Psychiatry
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