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Systematic investigation of childhood sleep-disordered breathing (SDB) in Beijing: validation of survey methodology
  1. Xiaodan Li1,
  2. Jun Tai1,
  3. Zhifei Xu2,
  4. Jun Ma3,
  5. Xiaoxia Peng4,
  6. Yongping Pan5,
  7. Xiaoyan Yan6,
  8. Guixiang Wang1,
  9. Yunxiao Wu7,
  10. Li Zheng1,
  11. Jiangnan Du,
  12. Wentong Ge1,
  13. Jie Zhang1,
  14. Yamei Zhang1,
  15. Xin Ni1,7
  1. 1 Department of Otolaryngology, Head and Neck Surgery, Beijing Children’s Hospital, Capital Medical University, Beijing, China
  2. 2 Respiratory Department, Beijing Children’s Hospital, Capital Medical University, Beijing, China
  3. 3 Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China
  4. 4 Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children’s Hospital, Capital Medical University, Beijing, China
  5. 5 Health Care Center of Primary and Middle School of Dongcheng District, Beijing, China
  6. 6 Clinical Institute of Peking University, Beijing, China
  7. 7 Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, Beijing, China
  1. Correspondence to Professor Xin Ni; nixin{at}


Objective To systematically investigate and validate the survey methodology for the epidemiological study of childhood sleep-disordered breathing (SDB) in mainland China using the Mandarin version of the Pediatric Sleep Questionnaire-Sleep-Related Breathing Disorder (PSQ-SRBD).

Design A cross-sectional study using randomised, stratified, multistage, cluster sampling method.

Setting A total of 11 kindergartens, 7 primary schools and 8 middle schools from 7 districts of Beijing, China.

Participants A total of 9198 children with valid questionnaires (4736 boys and 4462 girls; age range 3.0–14.4 years) were included.

Primary and secondary outcome measures Data on sociodemographic characteristics and PSQ-SRBD were collected. The score on PSQ-SRBD and the included factors were calculated with the effective data after data cleaning. Logistic regression and factor analysis with the principal components method were used to evaluate the validity of the questionnaire; reliability was assessed by retesting 5% of the respondents after 2±4 weeks of the initial test, and the intraclass correlation coefficient was calculated.

Results The effective response rate of80.54% matched the sociodemographic characteristics of the respondents with respect to age group ratio and sex ratio in Beijing. With regard to construct validity of the PSQ-SRBD, the item score, except that of ‘delayed growth’, was highly correlated to the SRBD score as assessed by the logistic regression model. The exploratory factor analysis displayed a credible construct validity, with majority of the items grouped as the original dimensions. The test–retest reliability coefficient of each dimension’s score ranged from 0.758 to 0.901, with an SRBD score of 0.730 indicating significant retest reliability.

Conclusions This study conducted and validated a successful survey methodology for investigation of childhood SDB in Beijing, China. The questionnaire demonstrated credible construct validity and retest reliability, thereby supporting the applicability and generalisability of the PSQ-SRBD in a large epidemiological survey of childhood SDB in China.

  • validation study
  • sleep disordered breathing
  • epidemiology
  • community child health
  • china

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  • XL and JT contributed equally.

  • Contributors XN served as the director of the survey. XN, JT, ZX, JM and XP were responsible for the design of the study and sampling. XL and GW were responsible for the on-site training and supervision. YW, LZ and JD were responsible for the survey arrangements.YP and XY completed the quality control of the questionnaries. JZ, YZ and WG were responsible for data management. XLand JT analysed the data and wrote the first draft of the paper. All authors contributed to the final manuscript. XN is the corresponding author and is responsible for the overall content as the guarantor.

  • Funding This work was supported by Beijing Municipal Science and Technology Project grant (Z161100000116050 and Z161100003216212) and Beijing Municipal Administration of Hospitals Clinical Technology Innovation Project grant (XMLX201701). This study was also supported by the Beijing Children’s Hospital, Capital Medical University, and the Institute of Child and Adolescent Health of Peking University.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Ethics approval Ethical approval was granted by the Ethics Committee of Beijing Children’s Hospital (BCH 2013-76).

  • Provenance and peer review Not commissioned; peer reviewed for ethical and funding approval prior to submission.

  • Data sharing statement No additional data are available.

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