Age‐Related Differences in Sleep Measures Among Pediatric Patients With Obstructive Sleep‐Disordered Breathing

ABSTRACT Objective To characterize age‐related differences in sleep measures among a cohort of pediatric patients referred for polysomnography (PSG) due to obstructive sleep‐disordered breathing (oSDB). Methods A retrospective review of 303 children aged 1–18 years referred for PSG due to oSDB was conducted. Patients were categorized into four age groups based on American Academy of Pediatrics guidelines. Demographic, clinical, and polysomnographic differences were analyzed using linear regression and chi‐square techniques. Sleep parameters were further characterized using correlation analysis and multiple linear regression. A subset of 133 patients was analyzed post‐tonsillectomy. Results The study included 6.6% patients aged 13 months to 2 years, 50.5% aged 2–5 years, 22.1% aged 6–11 years, and 20.8% aged 12–18 years. Obesity prevalence increased significantly with age, peaking at 75.8% in the 12–18‐year group ( p < 0.001). The apnea–hypopnea index (AHI) showed a U‐shaped distribution, with the highest level in the oldest (28.8/h) group ( p < 0.001). N3 sleep showed an inverse U‐shaped distribution, peaking in the 2–5‐year group (115.2 min, p < 0.001). Multiple regression analysis revealed significant negative associations between N3 duration and both age ( β = −1.90, p < 0.001) and AHI ( β = −0.41, p < 0.001), which persisted post‐tonsillectomy (age: β = −4.24, p < 0.001; AHI: β = −0.87, p = 0.001). Conclusion Age‐related differences in sleep parameters exist in children with oSDB and persist despite surgical intervention. These findings suggest that age and obesity continue to play crucial roles in sleep architecture, warranting further investigation. Level of Evidence 3.