Associations among sleep symptoms, physical examination, and polysomnographic findings in children with obstructive sleep apnea.

Abstract

The relationships among PSG findings, OSA symptoms, and tonsil and adenoid size are not clear. In this study, we aimed to investigate the associations between pediatric OSA and tonsil and adenoid size using subjective (OSA-18 questionnaire) and objective (PSG) measurements. 101 consecutive patients aged from 2 to 12years (mean age, 5.4 ± 2.2years; boys, 72.3%) diagnosed with OSA were enrolled in two age groups (2-6years group and 7-12years group) and underwent PSG and lateral cephalometric radiography. Tonsil size and the adenoid-nasopharyngeal (A/N) ratio were determined. Quality of life and sleep symptoms were measured using the Chinese version OSA-18 questionnaire. Demographic and clinical data were obtained. 75 and 26 patients were separately enrolled in 2-6years group and 7-12years group. In 2-6years group, the multiple linear regression revealed that tonsil size and A/N ratio were associated with log apnea-hypopnea index (AHI), and the Spearman's rank correlation reflected a positive correlation between log AHI and the OSA-18 sleep disturbance score (r = 0.362, P = 0.001). Log OSA-18 score was correlated with tonsil size (r = 0.349, P = 0.002) but not the A/N ratio in 2-6years group. Finally, no significant associations were observed between log OSA-18 scores and log AHI in all patients. As PSG stays the golden standard for diagnoses of pediatric OSA, physical examinations and quality-of-life assessments are needed to fully assess the impact of OSA on children.