1. All our comparisons will be against the apnea-hypopnea index (AHI) from the LPSG since it is the gold standard for diagnosing sleep apnea. The decision to run the LPSG and PM simultaneously is to exclude environmental and night to night variability. Furthermore, future studies can build on this study to compare LPSG against HST using PM systems in the home. Manual scoring of sleep studies can be costly and time consuming. A comparison between manual versus automatic scoring of the PM recordings as they relate to LPSG will shed light on the validity of automatic scoring in pediatric sleep studies which have more noise compared to adult sleep studies. Sleep questionnaires and radiographs are additional tools that clinicians use to screen for SA. The questionnaire we plan to study is made up of only 6 questions and can be much more attractive to both clinicians and patients. We plan to investigate how it compares to the most commonly used pediatric sleep questionnaire the PSQ. Clinicians use both 2D and 3D radiographic analyses to examine the airway. Given that 3D scans expose patients to more radiation, we plan to investigate the predictive value of 2D and 3D radiographic analyses as they relate to LPSG AHI. Validation of Diagnostic Approaches to Pediatric Sleep Apnea Ahmed I. Masoud 1,2, David W. Carley 3 1 UIC Graduate Program in Neuroscience, Chicago, IL, USA 2 Department of Orthodontics, UIC College of Dentistry, Chicago, IL, USA 3 Center of Narcolepsy, Sleep and Health Research, UIC College of Nursing, Chicago, IL, USA MATERIALS & METHODS INTRODUCTION EXPECTED RESULTS NULL HYPOTHESES 1.There is no difference in the diagnostic value of LPSG versus in-laboratory attended use of the Medibyte PM system in pediatric patients between the ages of 7 and 17. 2.There is no difference in the diagnostic value of manual versus automatic scoring of the Medibyte recordings in pediatric patients. 3.There is no difference between the pediatric sleep questionnaire (PSQ) and a recently proposed set of 6 hierarchically arranged questions (6Q) as they relate to the pre-test probability for SA in pediatric patients. 4.There is no difference in 2D and 3D airway analyses relative to the pre-test probability for SA in pediatric patients.  We Expect the respiratory disturbance index (RDI) from the PM using both manual and automatic scoring to be highly correlated with the AHI from the LPSG.  We expect the error demonstrated on Bland-Altman analysis to be larger when using automatic scoring compared to manual scoring  We expect the sensitivity and specificity of 6Q to be similar to that of the PSQ.  We expect a combination of 2D measurements in the 2D radiographic analysis to be more predictive of pediatric sleep apnea compared to 3D airway measurements. The prevalence of sleep apnea (SA) in children ranges from 1.2% to 5.7%. In addition to the consequences in adults, SA in children is associated with attention-deficit disorder (ADHD), other behavioral manifestations, failure to thrive, disturbances in cognitive development, increased utilization of health care services, and obesity. Overnight, attended, in-laboratory polysomnography (LPSG) is considered the gold standard in the diagnosis of SA. However, LSPG is expensive, time consuming, technically complex, and requires the patient to be at the laboratory. Sleeping in an unfamiliar environment can materially affect sleep behaviors, and this concern increases when patients are children. Moreover, there are significant delays in diagnosis and treatment of SA in pediatric patients due to the limited availability and access to LPSG which makes portable sleep monitors (PM) urgently needed. Timely diagnosis and management of pediatric SA is critical to prevent progressive associated comorbidities. The use of in home sleep testing (HST) is slowly growing to be an adjunct or an alternative to LPSG in some situations. Several studies have attempted to validate various PM systems used for HST in adults. However, such studies in pediatric patients are scarce. Because the pathophysiology and management of SA differs between adults and children these adult-specific data cannot be directly extrapolated to children. Sleep questionnaires and radiographs, both 2D and 3D, are additional tools that clinicians use to screen for SA. Most questionnaires are long and can discourage clinicians from using them. Recently, a new questionnaire was proposed that is composed of 6 questions and that has the potential to be much more attractive to both clinicians and patients. SIGNIFICANCE 60 x 7-17yrs ($20) LPSG PSQ 6Q PM UIC SLEEP SCIENCE CENTER UIC COLLEGE OF DENTISTRY 2D3D Exclusion Criteria: 1.Craniofacial anomalies 2.Neuromuscular disorders 3.Pregnancy using pregnancy urine HCG test SIMULTANEOUSLY Manual Scoring Correlation  Bland-Altman Linear Regression ROC Linear Regression Automatic Scoring Correlation  Bland-Altman The study protocol (#2015-0308) was approved by the Institutional Review Board of the University of Illinois at Chicago on May 28, 2015 by an expedited review process. IRB