Written by Hannah Harp
Spoon Feed
A scoring system used by clinicians to predict clinically significant obstructive sleep apnea (OSA) can reliably distinguish between non-clinically significant OSA and clinically significant OSA based on parent videos of their child’s sleep.
Counting more than just sheep
OSA occurs in 1-5% children and can lead to hypertension, behavioral issues, enuresis, growth delay, and CNS dysfunction. Polysomnogram (PSG) is the current gold standard for diagnosis of OSA. However, failure rates for these studies in children are high, and wait lists are long. This prospective diagnostic accuracy study evaluated whether smartphone video recordings analyzed using the VAPS Score could reliably predict clinically significant pediatric OSA as diagnosed by PSG.
Among 111 children aged 2–12 years, VAPS Score ≥3 had a sensitivity of 92% and specificity of 49%, while scores ≥7 had a specificity of 89% and sensitivity of 40%. In cases where parents confirmed capturing “worst breathing,” AUC improved to 85.45%, with sensitivity reaching 96%. The videos taken by parents in this study had very specific instructions, unlike the shaky unfocused videos of kids’ noses and mouths that I’m used to seeing in clinic. Additionally, videos still needed to be reviewed by a pediatric sleep specialist—but is the bottleneck at the availability of specialists, or at the level of available PSG appointments?
How will this change my practice?
Usually, I focus on reassurance after viewing parent videos of their kids sleeping. Now, instead, I will add more education by pointing out presence/absence of features of sleep-disordered breathing and reasons to refer to sleep medicine.
Source
Evaluating the diagnostic accuracy of smartphone video clips against polysomnography for paediatric obstructive sleep apnoea. Arch Dis Child. 2025 Jun 13:archdischild-2024-327775. doi: 10.1136/archdischild-2024-327775. Epub ahead of print. PMID: 40514188
