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Pediatric Sleep Questionnaire (Screening) Name of the child: Date of birth: Person completing this form: Date that you are completing the questionnaire: Instructions: Please answer the questions about.

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Paediatric Sleep Questionnaire (PSQ) For children aged 2–18 years, the scale has good internal consistency (α =0.88) with a sensitivity of 0.85 and specificity of 0.87 for identifying children with sleep related breathing disorders.

Paediatric Sleep Questionnaire (PSQ) The answers are scored as “0” (symptom absent) or “1” (symptom present) and the overall score is calculated as a proportion of positive answers with a score greater or equal to 0.33 being considered predictive for SDB (20).

The PSQ is a 22-item questionnaire developed and validated at the University of Michigan as a research tool to identify children at risk for sleep-related breathing disorders. It includes items intended to measure childhood sleep-related breathing disorder with subscores for snoring, sleepiness, and behavior.

The Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) is used to assess the level of excessive daytime sleepiness in children and adolescents. The ESS-CHAD is a modified version of the ESS that has been validated as a reliable measure of sleepiness in patients 12 to 18 years of age.

Answer these 8 questions Do you snore loudly (louder than talking or loud enough to be heard through closed doors)? Do you often feel tired, fatigued or sleepy during the day? Has anyone observed you stop breathing while you sleep? Do you have high blood pressure? Is your body mass index (BMI) more than 35?

Modified Pediatric Epworth Sleepiness Scale (Ages 6-16) A score of 10 or more is considered sleepy. A score of 18 or more is very sleepy. If you score 10 or more on this test, you should consider whether you are obtaining adequate sleep, need to improve your sleep hygiene and/or need to see a sleep specialist.

The mean response on nonmissing items is the score, which can vary from 0 to 1. Previous data suggest that a cutoff value of 0.33 would be most effective in identifying pediatric OSA.

0-5 lower normal daytime sleepiness. 6-10 normal daytime sleepiness. 11-12 mild excessive daytime symptoms. 13-15 moderate excessive daytime symptoms.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232