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Obstructive sleep apnea syndrome in children with cerebral palsy in Brazil: a multicenter study

Bruno Leonardo Scofano Dias1, Fernanda Marinho de Lima1, Daniela Fava1

  • 1Rede SARAH de Hospitais de Reabilitação, Brazil.

Jornal De Pediatria
|August 11, 2025
PubMed

Insights

High risk for obstructive sleep apnea syndrome (HR-OSAS) is more common in Brazilian children with cerebral palsy (CP), especially those with severe motor impairment (GMFCS V). Palatine tonsil hypertrophy is a key associated factor.

Area of Science:

  • Pediatric Neurology
  • Sleep Medicine
  • Public Health

Background:

  • Obstructive sleep apnea syndrome (OSAS) is a significant concern in children.
  • Cerebral palsy (CP) may increase the risk of OSAS due to various factors.
  • Screening tools are essential for identifying children at high risk.

Purpose of the Study:

  • To determine the prevalence of high risk for obstructive sleep apnea syndrome (HR-OSAS) in Brazilian children with CP.
  • To analyze the association of HR-OSAS with demographic, clinical, and functional variables, including the Gross Motor Function Classification System (GMFCS).
  • To evaluate the utility of the Pediatric Obstructive Sleep Apnea Screening Tool (PosaST).

Main Methods:

  • A multicenter, cross-sectional, exploratory study was conducted.
  • 312 Brazilian children with CP were included.
  • The Pediatric Obstructive Sleep Apnea Screening Tool (PosaST) was used for HR-OSAS screening.

Main Results:

  • The prevalence of HR-OSAS was 9.0% in children with CP (GMFCS I-V).
  • HR-OSAS prevalence was significantly higher in GMFCS V (14.7%) compared to GMFCS I-IV (6.4%).
  • Palatine tonsil hypertrophy was significantly associated with HR-OSAS, particularly in GMFCS V.

Conclusions:

  • HR-OSAS is more prevalent in Brazilian children with CP, especially in GMFCS V, compared to typically developing children.
  • Palatine tonsil hypertrophy is a significant risk factor for HR-OSAS in this population.
  • PosaST may be a useful screening tool for HR-OSAS in Brazilian children with CP, but further research is needed to establish cutoff scores.
Abstract

Keywords:
Cerebral palsyChildrenQuestionnaireRiskSleep apnea, Obstructive

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