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Characteristics and Frequency of Children With Severe Obstructive Sleep Apnea Undergoing Elective Polysomnography

Ashank Bains1, Elizabeth Abraham1, Adam Hsieh1

  • 1Boston University School of Medicine, Boston, Massachusetts, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|June 17, 2020
PubMed

Insights

Pediatric patients with sleep-disordered breathing have a 14.5% risk of severe obstructive sleep apnea (OSA). Young age and African American race are key predictors, not tonsil size.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Pulmonology

Background:

  • Obstructive sleep apnea (OSA) is a common sleep-disordered breathing condition in children.
  • Current guidelines by the American Academy of Otolaryngology (AAO) recommend polysomnography (PSG) for OSA evaluation.
  • Identifying children at high risk for severe OSA who may not meet current PSG criteria is crucial.

Purpose of the Study:

  • To determine the prevalence of severe pediatric obstructive sleep apnea (OSA).
  • To identify demographic and clinical predictors of severe OSA in children.
  • To assess the utility of current AAO guidelines in identifying severe OSA cases.

Main Methods:

  • Retrospective cohort study of 456 pediatric patients undergoing polysomnography (PSG) for sleep-disordered breathing.
  • Data collected included demographics (age, sex, race, insurance) and clinical findings (symptom severity, tonsil size).
  • Univariate analysis was used to identify significant predictors of severe OSA.

Main Results:

  • 14.5% of pediatric patients evaluated had severe OSA.
  • African American children had 3.7 times higher odds of severe OSA compared to white children.
  • Children aged 2-3 years had 2.2 times higher odds of severe OSA compared to those aged 4-6 years.

Conclusions:

  • Young age and African American race are significant predictors of severe OSA in pediatric patients.
  • Clinical findings like tonsil size and symptom severity were not significant predictors of severe OSA.
  • A notable percentage of pediatric patients with sleep-disordered breathing may have severe OSA, underscoring the need for careful evaluation beyond current guideline criteria.
Abstract

Keywords:
AAO-HNSF guidelinesdiagnostic polysomnographyelective polysomnographypatient safetysevere obstructive sleep apneasleep-disordered breathing

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