{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T14:53:07Z","timestamp":1791125587074,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Screening and treatments for pediatric obstructive sleep apnea (pOSA) often use adult symptoms and conventional surgical approaches. This study tested the hypothesis that symptoms and treatment efficacy for OSA differ across age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single\u2010center cohort study of 0 to 18\u2010year\u2010olds who were managed and underwent polysomnography (PSG) in a pediatric\u2010dedicated sleep medicine center from 2020 to 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 491 children, 489 had pOSA, 57.7% were male, the median age was 6\u2009years old (IQR1\u20103, 4\u20139), and 41% already had an adeno\u2010 or adenotonsillectomy prior to the PSG. Only 15.6% were obese, and 13.2% had an Epworth Sleepiness Score over 10. Snoring was not the most prevalent nocturnal symptom: restlessness (91.6%), chronic insomnia (86.1%), kicking legs (82.0%), and frequent awakening (78.4%) were all more common. Neurocognitive issues, present in 93.7%, were most commonly mood swings (86.5%) and ADHD (51.9%). Of the 270 without surgery before the PSG, 72.2% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009195) were referred, and 173 had surgery. Positive airway pressure (PAP) was prescribed for 240 (49.1%) patients, 176 (73%) of whom had enough CPAP usage to provide machine\u2010estimated apnea\u2010hypopnea index (AHI). After adenotonsillectomy, 27.0% had a post\u2010operative AHI under 5 events per hour, and 73.1% had improvement in neurocognitive issues while that was 94.9% and 87.2% in those using PAP, respectively. After adjusting for age and AHI, PAP had threefold (aOR 3.85, 95%CI 1.39\u201310.67) higher odds of improving neurocognitive issues than surgery,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The majority of children with pOSA are not tired or obese. Insomnia and restless sleep are more common than snoring. Daytime neurocognitive issues affect almost all children with pOSA and improve with treatment, especially PAP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71865","type":"journal-article","created":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T14:16:51Z","timestamp":1791123411000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Snoring, Sleepiness and Surgery: Update on the Prevalent Symptoms of and Treatment Effects in all Age Groups With Pediatric Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9684-814X","authenticated-orcid":false,"given":"Amanda B.","family":"Hassinger","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pulmonology and Sleep Medicine University at Buffalo School of Medicine and Biomedical Sciences, Attending Physician, Golisano Children's Hospital of Buffalo Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Granger","sequence":"additional","affiliation":[{"name":"Resident Physician, Department of Family Medicine, Virginia Commonwealth University Bon Secours St. Francis Medical Center Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0879-9787","authenticated-orcid":false,"given":"Alexa","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Medical Student University at Buffalo Jacobs School of Medicine and Biomedical Sciences Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Li","sequence":"additional","affiliation":[{"name":"Medical Student University at Buffalo Jacobs School of Medicine and Biomedical Sciences Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mine","family":"Varol","sequence":"additional","affiliation":[{"name":"Fellow Physician, Division of Sleep Medicine University of Missouri\u2010Kansas City Schol of Medicine, Children's Mercy Hospital\u2010 Kansas City Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2112-1218","authenticated-orcid":false,"given":"Aysenur","family":"Danis","sequence":"additional","affiliation":[{"name":"Resident Physician, Department of Pediatrics University at Buffalo School of Medicine and Biomedical Sciences, Attending Physician, Golisano Children's Hospital of Buffalo Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1152\/physrev.00032.2011","article-title":"Control of Sleep and Wakefulness","volume":"92","author":"Brown R. 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