Original article Are physicians aware of obstructive sleep apnea in children? Zeynep Tamay a, * , Ahmet Akcay b , Gurkan Kilic a , Ayse Suleyman a , Ulker Ones a , Nermin Guler a a Division of Allergy and Chest Diseases, Department of Pediatrics, Istanbul Medical Faculty, C ¸ apa, 34390 Istanbul, Turkey b Department of Pediatrics, Pamukkale Medical Faculty, Pamukkale, Turkey Received 31 January 2006; received in revised form 11 April 2006; accepted 21 April 2006 Abstract Background and purpose: Childhood obstructive sleep apnea (OSA) affects 1–3% of preschool children. If left untreated, it can result in serious morbidity including growth retardation, cor pulmonale, and neurocognitive deficits, such as poor learning and behavioral problems. Early recognition and treatment is important to prevent morbidity and sequela and to provide better quality of life both for the child and his or her family members. The purpose of this study was to elucidate the knowledge and attitude physicians have about pediatric OSA, using the Obstructive Sleep Apnea Knowledge and Attitudes in Children (OSAKA-KIDS) questionnaire. Patients and methods: The first section of the OSAKA-KIDS questionnaire, which includes 18 items presented in a true-or-false format, was developed to assess the knowledge physicians have about pediatric OSA. The second section, including five items, was developed to assess attitudes and was measured on a five-point Likert scale ranging from 1 to 5. Results: A total of 230 questionnaires were completed by physicians: 138 (60.3%) pediatricians, 70 (30.5%) general practitioners and 21 (9.2%) pulmonologists. The mean total knowledge score was 66.7%. The knowledge score positively correlated with having sub-specialty training (rZ0.205, PZ0.002) and negatively correlated with having a higher degree (rZK0.283, P!0.001). The mean total attitude score was 3.4. The knowledge score positively correlated with the attitude score (rZ0.27, P!0.001). Conclusions: This study shows that among physicians there are deficits in knowledge about childhood OSA and its treatment. More focused educational programs are needed within medical schools and within pediatric residency and post-graduate training programs. q 2006 Elsevier B.V. All rights reserved. Keywords: Children; Obstructive sleep apnea; Physician; Pediatrician 1. Introduction Although childhood obstructive sleep apnea (OSA) was described more than a century ago [1], it has gained importance only in recent decades since the first scientific case series reported by Guilleminault et al. [2] appeared. Childhood OSA is a syndrome affecting 1–3% of preschool children [3–5]. If left untreated, it can result in serious morbidity, including growth retardation, cor pulmonale and neurocognitive deficits such as poor learning and behavioral problems [6–10]. Severe cases may even result in death. Childhood OSA differs from adult type in its etiology, clinical manifestations, polysomnographic characteristics and sequela [4,11]. Early recognition and treatment is important to prevent morbidity and sequela and to provide better quality of life for both the child and his or her family members. Studies conducted to investigate the training, knowledge, and practices of pediatricians regarding sleep and sleep disorders in children and adolescents demonstrated that significant gaps exist in the management of this issue among pediatricians [12,13]. The Obstructive Sleep Apnea Knowl- edge and Attitudes in Children (OSAKA-KIDS) ques- tionnaire was recently developed by Uong et al. [14] for use in measuring physicians’ knowledge and attitudes about childhood OSA. They reported deficits in basic knowledge about childhood OSA among pediatricians and family practitioners and emphasized the need for more focused education on this subject. Pediatricians and primary care physicians have a primary role in the assessment of children’s health care in Turkey and thus should have Sleep Medicine 7 (2006) 580–584 www.elsevier.com/locate/sleep 1389-9457/$ - see front matter q 2006 Elsevier B.V. All rights reserved. doi:10.1016/j.sleep.2006.04.004 * Corresponding author. Tel.: C90 212 4142196; fax: C90 212 6319301. E-mail address: eztamay@yahoo.com (Z. Tamay).