{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:55:45Z","timestamp":1768524945185,"version":"3.49.0"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T00:00:00Z","timestamp":1616630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify predictors of severe obstructive sleep apnea (OSA) in children under 3\u2009years of age and to compare demographics, comorbidities, and polysomnographic characteristics of infants and toddlers with OSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined children under 3\u2009years of age who had polysomnogram between August 2012 and March 2020. Demographics, clinical, and polysomnographic parameters were compared in children age 0\u20131 versus 1\u20133\u2009years and 0\u20132 versus 2\u20133\u2009years and severe versus mild\u2013moderate OSA. Univariate analysis was used to compare age groups; multiple logistic regression for predictors of severe OSA. Significance was set at <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 413 children, 267 (65%) were male and 131 (32%) obese. The population included Hispanic (41%), African\u2009American (28%), and Caucasian (25%) children. A total of 98.5% had OSA and 35% had severe OSA. Children under 1\u2009year of age more commonly had gastroesophageal reflux disease (GERD) (38% vs. 23%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.014); tonsillar hypertrophy was more common in children over 2\u2009years of age (56% vs. 34%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). Down syndrome (odds ratio (OR): 3.16, 95% confidence interval (CI)\u00a0=\u00a01.14\u20138.68, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.026) and tonsillar hypertrophy (OR: 1.97, 95% CI\u00a0=\u00a01.28\u20133.02, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002) were predictors of severe OSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Children under 3\u2009years of age with OSA are more likely to be male and have GERD. Down syndrome and tonsillar hypertrophy are predictors of severe OSA, and children with these conditions should be prioritized for polysomnography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E2603\u2013E2608, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29536","type":"journal-article","created":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T12:06:20Z","timestamp":1616673980000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Obstructive Sleep Apnea in Children Under 3\u2009Years of Age"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1112-4693","authenticated-orcid":false,"given":"Swathi","family":"Rayasam","sequence":"first","affiliation":[{"name":"UT Southwestern Medical School  Dallas Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2322-5347","authenticated-orcid":false,"given":"Romaine","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Pediatric Otolaryngology UT Southwestern and Children's Medical Center  Dallas Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Lenahan","sequence":"additional","affiliation":[{"name":"University of Southern California Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Abijay","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical School  Dallas Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7890-0541","authenticated-orcid":false,"given":"Ron B.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Division of Pediatric Otolaryngology UT Southwestern and Children's Medical Center  Dallas Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.6.1255-a"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200708-138MG"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(03)00182-4"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2009.04.003"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.12.010"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.04.003"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.01.034"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.4686"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221511200237X"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2011.07.035"},{"key":"e_1_2_6_12_1","unstructured":"BMI\u2010for\u2010age tables. 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