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How is Obstructive Sleep Apnea defined on PSG in adults and in children?
In adults, the polysomnographic recording will show at least five or more scorable respiratory events per hour of sleep, with evidence of increased respiratory effort during all or a portion of each respiratory event.
In children, the polysomnographic recording will show at least one or more scorable respiratory events per hour of sleep.
The below table compares the diagnostic criteria for OSA in adults and children per the ICSD-3.
Diagnostic Criteria of Obstructive Sleep Apnea in Adult and Pediatric Populations
| Adult (Criteria [A and B] or C Must Be Met) | Pediatric (Criteria A and B Must Be Met) |
|---|---|
| A. The presence of one or more of the following: 1. The patient has excessive daytime sleepiness, fatigue, or insomnia symptoms 2. The patient reports breath holding, gasping, or choking during sleep 3. The bed partner reports habitual snoring, interruptions in breathing, or both during sleep 4. The patient has hypertension, a mood disorder, cognitive dysfunction, coronary artery disease, stroke, congestive heart failure, atrial fibrillation, or type 2 diabetes B. Polysomnography demonstrates five or more obstructive respiratory events per hour of sleep OR C. Polysomnography demonstrates 15 or more obstructive respiratory events per hour of sleep | A. The presence of one or more of the following: 1. Snoring 2. Labored, paradoxical, or obstructed breathing during sleep 3. Sleepiness, hyperactivity, behavioral problems, or learning problems B. PSG demonstrates one or both of the following: 1. One or more obstructive respiratory events per hour of sleep OR 2. A pattern of obstructive hypoventilation, defined as at least 25% or total sleep time with hypercapnia (PaCO 2 > 50 mm Hg) in association with one or more of the following: 1. Snoring 2. Flattening of the inspiratory nasal pressure waveform 3. Paradoxical thoracoabdominal motion |
