CLINICAL AND ANATOMICAL FACTORS ASSOCIATED WITH OBSTRUCTIVE SLEEP APNEA SEVERITY IN CHILDREN: A PROSPECTIVE PRELIMINARY STUDY

Adrijana Ugrinoska Pandeva; Tatjana Jakjovska Maretti; Katerina Boshkovska; Vesna Dzambazovska

Adrijana Ugrinoska Pandeva Public Health Institution University Clinic for Respiratory Diseases in Children Kozle, North Macedonia
Tatjana Jakjovska Maretti Public Health Institution University Clinic for Respiratory Diseases in Children Kozle, North Macedonia, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Katerina Boshkovska Public Health Institution University Clinic for Respiratory Diseases in Children Kozle, North Macedonia, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
Vesna Dzambazovska Public Health Institution University Clinic for Respiratory Diseases in Children Kozle, North Macedonia

Abstract

Abstract

Introduction: Pediatric obstructive sleep apnea (OSA) is a multifactorial disorder characterized by recurrent upper airway obstruction during sleep, leading to intermittent hypoxia and sleep fragmentation. Although adenotonsillar hypertrophy is the primary anatomical risk factor, disease severity may be influenced by additional variables including age, obesity and allergic status. Objective: To evaluate the association between adenotonsillar hypertrophy, age, body mass index (BMI), allergic status and OSA severity measured by the apnea-hypopnea index (AHI). Methods: A prospective analytical study was conducted in a preliminary cohort of 26 children aged 3-14 years with suspected OSA. Participants underwent overnight cardiorespiratory polygraphy, otorhinolaryngological assessment including Brodsky tonsillar grading and endoscopic adenoid grading, anthropometric evaluation, allergy history assessment and completion of the Pediatric Sleep Questionnaire (PSQ). Associations between clinical variables and AHI were analyzed using nonparametric statistical methods. Results: Mild OSA predominated (88.5%). No significant associations were observed between AHI and adenotonsillar hypertrophy grade, age, BMI or allergic status. A significant positive correlation was identified between PSQ total score and AHI (p 0.023). Conclusion: In this preliminary cohort, OSA severity was not significantly associated with anatomical hypertrophy, age, obesity or allergic status. Symptom burden assessed by PSQ correlated with objective disease severity, supporting its value as a screening tool. Larger studies are required to clarify the multifactorial determinants of pediatric OSA severity.

Keywords: pediatric OSA, adenotonsillar hypertrophy, BMI, allergy, AHI

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