Impact of obstructive sleep apnea on language development in Arabic-speaking children

Pediatric Obstructive Sleep Apnea (OSA) occurs during critical neurodevelopmental windows, often leading to deficits in attention and information processing. OSA is increasingly recognized as a condition associated with impaired language acquisition and highlights the necessity for early clinical language screening in this population. Thus, this study aimed to explore the impact of childhood OSA on language development in children aged 2 to 7.4 years. 41 native Arabic-speaking children diagnosed with OSA were evaluated. Assessments included clinical history, the Arabic Pediatric Sleep Questionnaire (A-PSQ), and physical examinations by Brodsky and Modified Mallampati scales. Diagnosis was confirmed via flexible nasopharyngoscopy, lateral neck radiography (A/N ratio), and polysomnography (AHI≥1). Language and cognitive profiling were conducted using the Stanford-Binet Intelligence Scale (5th ed.) and the Modified Preschool Language Scale-4 (Arabic version).

Receptive language age demonstrated a strong negative correlation with AHI (r = -0.622, p < 0.001), while expressive and total language ages showed significant moderate negative correlations (r=-0.527 and -0.544, respectively; p<0.001). Linear regression identified the Brodsky scale, Mallampati classification, endoscopic adenoid grade, and A-PSQ domains as significant positive predictors of AHI. Conversely, endoscopic adenoid grade and Mallampati classification were significant negative predictors for all language domains, with the A-PSQ snoring domain specifically impacting expressive and total language ages.

Significant correlations exist between anatomical obstruction, OSA severity, and language delay. Mallampati score, endoscopic grade, and A-PSQ snoring domain constitute a "High-Risk Triad" of OSA. The presence of this triad in children with language delay warrants immediate prioritization for intervention to mitigate long-term neurodevelopmental morbidity.