Obstructive Sleep Apnea in Children with Autism Spectrum Disorder

STUDY OBJECTIVES: To describe the demographic and clinical characteristics of children with autism spectrum disorder (ASD) referred for polysomnography (PSG) and to look for predictors of obstructive sleep apnea (OSA) and severe OSA in these children. METHODS: This is a retrospective case series of children ages 2-18 years who underwent PSG between January 2009 and February 2015. Children were excluded if they had major comorbidities, prior tonsillectomy, or missing data. The following information was collected: age, gender, race, height, weight, tonsil size, and prior diagnosis of allergies, asthma, gastroesophageal reflux disease (GERD), seizure disorder, developmental delay, cerebral palsy (CP) or attention deficit hyperactivity disorder (ADHD). Predictors of OSA were evaluated. RESULTS: A total of 45 children were included with a mean (SD) age of 6.1 (2.8). The patients were 80% male, 49% Hispanic, 27% African American, 22% Caucasian, and 2.2% other. Of these children 26 (58%) had OSA (apnea hypopnea index, AHI >1) and 15 (33%) were obese (body mass index, BMI z-score ≥ 95th percentile). The mean (SD) AHI was 7.7 (15.0) (range 1.0-76.6). A total of 9 (20%) had severe OSA (AHI≥10). There were no demographic or clinical predictors of OSA in this group. However, increasing weight served as a predictor of severe OSA and children who were of African American or Hispanic race had the tendency to be more likely obese. CONCLUSION: The absence of demographic or clinical predictors of OSA supports using general indications for polysomnography in children with ASD.