PEDOSA-7: Development, Validation, and Clinical Utility of a Simplified Screening Tool for Pediatric Obstructive Sleep Apnea—A Pilot Study

Introduction: Pediatric obstructive sleep apnea (OSA) remains underdiagnosed due to reliance on complex screening tools. This pilot study developed and validated the PEDOSA-7, a 7-item binary-response (Yes/No) questionnaire, to streamline OSA screening. Materials and Methods: A cross-sectional analysis of 83 children (aged from 3 to 16 years) with sleep complaints compared PEDOSA-7 performance with polysomnography (apnea–hypopnea index (AHI) ≥5 for OSA) and the Pediatric Sleep Questionnaire (PSQ). Results: Of the cohort, 31.3% (26/83) had OSA (AHI ≥5). The OSA group exhibited a higher mean body mass index (BMI; 22.3 vs. 18.0; P < 0.05) and a strong BMI–AHI correlation ( r = 0.73). PEDOSA-7 demonstrated sensitivity of 84.6%, specificity of 54.4%, negative predictive value (NPV) of 88.6%, and area under the curve of 0.728 at a cutoff score ≥3. Key items (snoring and breathing pauses) showed high sensitivity (92%). Internal consistency was suboptimal (Cronbach α = 0.49), reflecting item redundancy. Compared with PSQ, PEDOSA-7 achieved better sensitivity (PSQ: 61.3%) with superior practicality due to its binary scoring. Lowering the AHI threshold to >1 improved specificity (83.3%) but reduced sensitivity (37.1%), highlighting trade-offs in screening accuracy. Discussion: PEDOSA-7 offers a rapid, clinician-friendly tool for OSA risk stratification, particularly in resource-limited settings, with a high NPV minimizing unnecessary referrals. Limitations include a small, gender-imbalanced sample (non-OSA group: all males) and a lack of cultural/age diversity. Future studies should validate the tool in larger cohorts and refine its psychometric properties. Conclusion: The PEDOSA-7 balances diagnostic accuracy and usability, serving as an alternative screening tool to improve OSA detection. Furthermore, validation in diverse populations is warranted.