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Updated: Nov 11, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Obstructive Sleep Apnea in Children Under 3 Years of Age

Swathi Rayasam1, Romaine Johnson2, Danielle Lenahan3

  • 1UT Southwestern Medical School, Dallas, Texas, U.S.A.

The Laryngoscope
|March 25, 2021
PubMed

Insights

Severe obstructive sleep apnea (OSA) in children under 3 years old is more common in males and those with GERD. Down syndrome and tonsillar hypertrophy predict severe OSA, warranting prioritized polysomnography.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Genetics

Background:

  • Obstructive sleep apnea (OSA) affects young children, with unique demographic and comorbidity profiles.
  • Identifying predictors of severe OSA in infants and toddlers is crucial for timely diagnosis and intervention.

Purpose of the Study:

  • To determine factors predicting severe OSA in children under 3 years.
  • To compare characteristics of OSA in different age groups (infants vs. toddlers) and severity levels.

Main Methods:

  • Retrospective case series analysis of 413 children under 3 years undergoing polysomnography.
  • Comparison of demographics, comorbidities (e.g., GERD, tonsillar hypertrophy), and polysomnographic data.
  • Logistic regression used to identify predictors of severe OSA.

Main Results:

  • Obstructive sleep apnea (OSA) was prevalent (98.5%), with 35% having severe OSA.
  • Children under 1 year had higher rates of gastroesophageal reflux disease (GERD).
  • Down syndrome (OR: 3.16) and tonsillar hypertrophy (OR: 1.97) were significant predictors of severe OSA.

Conclusions:

  • Male sex and GERD are associated with OSA in children under 3.
  • Down syndrome and tonsillar hypertrophy are key predictors of severe OSA in this age group.
  • Prioritization for polysomnography is recommended for children with Down syndrome and/or tonsillar hypertrophy.
Abstract

Keywords:
Obstructive sleep apneapediatricssurgical treatment of obstructive sleep apnea

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