中文版兒童睡眠問卷於睡眠呼吸障礙患者之信效度研究

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

目的：英文版兒童睡眠問卷 (PSQ)，己証實在篩檢兒童青少年睡眠呼吸中止症有不錯 的信效度。本研究的目的是在研究分析中文版 (CPSQ) 於診斷睡眠呼吸障礙上的信效度。方 法：本研究收集6-15 歲確定診斷睡眠呼吸中止症兒童青少年共127 人，及對照組正常健康 小孩46 人。二組均接受一晚睡眠檢查及量表評估，並在一個月之後再接受一次量表評估。 結果：量表分析結果顯示，內部一致性均在可接受範圍內。在各分項的Cranach’s α 為「打 呼」＝ 0.815、「張口呼吸」＝ 0.73、「白天嗜睡」＝ 0.62、「過動不專心行為」＝ 0.852 及 「睡眠呼吸疾病」＝ 0.826；至於Spearman’s correlation coefficients 顯示再測信效度為中度以 上相關性（「打呼」＝ 0.862、「張口呼吸」＝ 0.742、「SRBD 」＝ 0.786、「白天嗜睡」＝ 0.760、「行為問題」＝ 0.868、「其他症狀」＝ 0.685 ）。故結果顯示CPSQ 在評估兒童青少 年的睡眠呼吸問題 (SDB) 有良好的信效度。同時在ROC 分析上，我們發現 snoring 及SRBD 二個分項對診斷SRBD 有中度以上的敏感性。結論：CPSQ 是一個好的測量工具，特別用在 篩檢兒童青少年睡眠呼吸中止疾病上。

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.