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CME/MOC

Sleep Related Questionnaires

Paediatric Sleep questionnaire (PSQ)

Name of questionnaire Pediatric Sleep Questionnaire
Type of original questionnaire-description, age/population SRBD scale contains 22 symptom items that ask about snoring frequency, loud snoring, observed apneas, difficulty breathing during sleep, daytime sleepiness, inattentive or hyperactive behavior, and other pediatric OSA features.
Children aged 2±18 years who had polysomnographically-confirmed sleep disordered breathing (n = 54).
Number of items 22 symptom items
Number of domains & categories 3 domains
Name of categories/domains Subscales within the SRBD scale include a 4-item sleepiness scale, a 4-item snoring scale, and a 6-item in- attention/hyperactivity scale
Scaling of items Responses are "yes" = 1, "no" = 0, and "don't know"=missing. The mean response on nonmissing items is the score, which can vary from 0 to 1. Scores >0.33 are considered positive and suggestive of high risk for a pediatric sleep-related breathing disorder.
   
Scoring test-retest reliability The two administrations revealed a Spearman correlation coefficient r of 0.92 for the snoring scale (P < 0.0001), 0.66 for the sleepiness scale (P = 0.0010), 0.83 for the behavior scale (P < 0.0001), and 0.75 for the SRBD scale (P < 0.0001).
The mean differences between raw scores on successive administrations (2nd minus 1st) of each scale were 0.00±0.11, −0.04±0.23, 0.00±0.11, and −0.02±0.07, respectively, none of which approached statistical significance (paired t-tests, P >0.2 for each).
Scoring Internal consistency Cronbach's alpha for each scale: snoring scale, 0.86; sleepiness scale, 0.66; behavior scale, 0.84; and SRBD scale, 0.89.
Validity Sensitivity of 0.85 and a specificity of 0.87
Available forms (short and/or long etc.) One form
Language English
Translations in other languages (if yes, then list the languages) Chinese, Greek, Hindi, Spanish, Turkish
Developer(s) name Ronald D. Chervin, M.D.
Developer contact information for permission Department of Neurology, University of Michigan, Ann, Arbor, USA
chervin@med.umich.edu
Availability of questionnaire: needs permission from developer, cost or freely available Freely available for academic and research use 
Limitations
Link to the questionnaire (if available)

The PSQ is available to be licensed free of charge for academic and research use at:

3766 - Pediatric Sleep Questionnaire — Designed as Research Screen for Symptoms of Obstructive Sleep Apnea and Other Sleep Disorders in Children | Umich Flintbox

Other comments

May be used in conjunction with objective testing of pediatric sleep disordered breathing.  
Can offer insight into comorbidities, long term prognosis and surgical responses Found to have high diagnostic value for screening patients with suspected OSA. For children with central system malformations, PSQ could be used to prioritize which patients need a PSG more urgently than others.
Can be used as a reasonable first-line screening tool for OSA in children with asthma

Patient populations in who questionnaire has been validated Children with suspected sleep disordered breathing
References (including original publication, validity and reliability in different countries/languages, populations and long/short versions)
  1. Chervin RD1, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med. 2000 Feb 1;1(1):21-32.
  2. Ferry AM, Wright AE, Ohlstein JF, Khoo K, Pine HS. Efficacy of a Pediatric Sleep Questionnaire for the Diagnosis of Obstructive Sleep Apnea in Children. Cureus. 2020;12(12):e12244. Published 2020 Dec 23. doi:10.7759/cureus.12244
  3. Wu CR, Tu YK, Chuang LP, et al. Diagnostic meta-analysis of the Pediatric Sleep Questionnaire, OSA-18, and pulse oximetry in detecting pediatric obstructive sleep apnea syndrome. Sleep Med Rev. 2020;54:101355. doi:10.1016/j.smrv.2020.101355
  4. Umano GR, Rondinelli G, Luciano M, et al. Pediatric Sleep Questionnaire Predicts Moderate-to-Severe Obstructive Sleep Apnea in Children and Adolescents with Obesity. Children (Basel). 2022;9(9):1303. Published 2022 Aug 27. doi:10.3390/children9091303
  5. Pabary R, Goubau C, Russo K, Laverty A, Abel F, Samuels M. Screening for sleep-disordered breathing with Pediatric Sleep Questionnaire in children with underlying conditions. J Sleep Res. 2019;28(5):e12826. doi:10.1111/jsr.12826
  6. Beltran Ale G, Pascoe J, George A, et al. Validation of pediatric sleep questionnaire in children with Chiari malformation and/or spina bifida with or without myelomeningocele. Sleep Med. 2021;84:93-97. doi:10.1016/j.sleep.2021.05.030
  7. Masoud AI, Adavadkar PA, Park C, Gowharji LF, Alwadei AH, Carley DW. Comparing two pediatric sleep questionnaires: The Pediatric Sleep Questionnaire (PSQ) and a set of 6 hierarchically arranged questions (6Q). Cranio. 2022;40(4):303-312. doi:10.1080/08869634.2020.1792221
  8. Ehsan Z, Kercsmar CM, Collins J, Simakajornboon N. Validation of the pediatric sleep questionnaire in children with asthma. Pediatr Pulmonol. 2017;52(3):382-389. doi:10.1002/ppul.23568
  9. Dooley AA, Jackson JH, Gatti ML, et al. Pediatric sleep questionnaire predicts more severe sleep apnea in children with uncontrolled asthma. J Asthma. 2021;58(12):1589-1596. doi:10.1080/02770903.2020.1818775
  10. Certal V, de Lima FF, Winck JC, Azevedo I, Costa-Pereira A. Translation and cross-cultural adaptation of the Pediatric Sleep Questionnaire into Portuguese language.Int J Pediatr Otorhinolaryngol. 2015;79:175-8.
  11. Wang CH, Yang CM, Huang YS. The Validation and Reliability of Chinese Version of the Pediatric Sleep Questionnaire for Patients with Sleep Breathing Problem. Taiwan J Psychiatry. 2012;26:177–86.
  12. Tomás Vila M, Miralles Torres A, Beseler Soto B. Versión Española del Pediatric Sleep Questionnaire. Un instrumento útil en la investigación de los trastornos del sueño en la infancia. Análisis de su fiabilidad.Ann Pediatr. 2007;66:121–8.
  13. Yüksel H, Söğüt A, Yılmaz O, Kutluay Reliability and validity of the Turkish version of the pediatric sleep questionnaire: a tool for prediction of sleep related breathing disorder. Tuberk Toraks 2011;59(3):236-41.
  14. Gupta R, Ali R, Verma S, et al. Study of Sleep Disorders among Young Children Using Hindi Translated and Validated Version of Pediatric Sleep Questionnaire. J Neurosci Rural Pract. 2017;8(2):165-169. doi:10.4103/jnrp.jnrp_428_16
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Updated by Reem Itani, MD
Date of last update 11/2022