Age-dependent association between parent-reported snoring and polysomnography findings in children

The initial identification of children at risk for sleep disordered breathing (SDB) commonly relies on parental reports of symptoms, particularly snoring. This study aims to assess how age affects the association between parent-reported snoring and SDB-related findings on polysomnography (PSG). We hypothesized that parent-reported snoring correlates more strongly with SDB-related findings on PSG in younger children.

This study was part of the Child Sleep project, a longitudinal birth cohort study on children born at Tampere University Hospital, which was carried out between 2013 and 2025 and included clinical examinations at ages 2, 6, and 12 years, where children were compared based on whether their parents reported them to snore.

An association between parent-reported snoring and PSG-diagnosed obstructive sleep apnea (OSA) was found in children aged 2 years (p = 0.009) and 6 years (p = 0.045). Parent-reported snoring showed a high sensitivity (1.0) and negative predictive value (1.0) for OSA in both 2- and 6-year-olds, with its predictive performance diminishing in 12-year-olds. 2-year-olds who were reported to snore had higher respiratory effort than non-snorers (p = 0.022). In children aged 6 and 12 years there was more flow limitation among those reported to snore than among non-snorers.

Parent-reported snoring may be a clinically useful screening tool for excluding SDB in younger children alongside other examination methods. However, its reliability appears to decrease as children approach puberty and during puberty. Thus, it is important to consider age-related changes in the pathophysiology of SDB and changes in parental observational behavior as children approach adolescence.