Clinical predictors of pediatric obstructive sleep apnea: Demographic and physical factors

Objective: To identify clinical predictors of obstructive sleep apnea (OSA) in pediatric patients undergoing level I polysomnography (PSG). Methods: We retrospectively analyzed children aged ≤12 years who underwent level I PSG. Correlation analyses were performed to examine the relationships between clinical variables and PSG parameters. Multiple linear regression analysis was conducted to identify predictors of the apnea-hypopnea index (AHI), using age, sex, tonsil grade, adenoid ratio, and body mass index (BMI) percentile as candidate variables. Subgroup analysis was performed by stratifying patients into preschool-aged (<6 years) and school-aged (≥6 years) groups. Results: In the total population, older age, male sex, higher tonsil grade, and higher BMI percentile were positively associated with AHI. Subgroup analysis revealed that tonsil grade was the only significant predictor of AHI in the preschool-aged group. In the school-aged group, age and BMI percentile emerged as additional predictors of AHI, whereas the influence of tonsil grade, though still significant, was reduced. Conclusions: Older age, male sex, tonsillar hypertrophy, and obesity were significant predictors of AHI in children. Tonsillar hypertrophy played a more prominent role in younger children, while the influence of age and BMI percentile increased in older children. These findings highlight the importance of age-tailored evaluation in assessing OSA risk in pediatric populations.