Clinical Parameters Predicting Obstructive Sleep Apnoea Syndrome and Its Severity in Children Referred to a Sleep...

Paediatrics obstructive sleep apnoea syndrome (OSAS) is often underdiagnosed by medical practitioners due to its subtle and nonspecific symptoms in children. This study aimed to determine the prevalence of OSAS and identify clinical predictors of its occurrence and severity.

Medical records of children (2-18 years) who underwent polysomnography (PSG) at a sleep laboratory in Myanmar during 2012-2023 were reviewed retrospectively. Children with incomplete PSG data, a prior PSG record in the same sleep laboratory, or a history of adenotonsillectomy were excluded from the study.

This study included 349 children with mean ± SD age 6.8 ± 2.8 year. OSAS was identified in 82.2% (289/349). Boys, overweight/obesity and tonsil grade-4 were independently associated with OSAS and boys, overweight/obesity, lower resting SpO₂, witnessed apnoea, abnormal daytime sleepiness and tonsil grade-4 were independently associated with severe OSAS on multivariable logistic regression. Among 2-8-year-old children, there was a significant mild positive correlation between AHI and tonsil grades (r = 0.29, p < 0.001) and between AHI and BMI (r = 0.21, p < 0.001). Among 9-18-year-old children, there is a moderate positive correlation between AHI and BMI (r = 0.34, p = 0.003); however, the correlation between AHI and tonsil grades was not significant r = 0.08 (p = 0.51).

Male sex, overweight/obesity and tonsil grade-4 can predict OSAS and its severity in children. Lower SpO₂ levels, witnessed apnoea and excessive daytime sleepiness can also predict severe OSAS. Although the degree of obesity is correlated with OSAS severity in both older and younger children, the degree of tonsil grades is correlated with its severity only in younger children.