Construction of a nomogram for individualized prediction of obstructive sleep apnea syndrome risk in snoring children.

OBJECTIVE

To develop and validate a nomogram for the individualized prediction of obstructive sleep apnea syndrome (OSAS) risk in children presenting with snoring.

METHODS

This retrospective study included 294 children with snoring admitted to our hospital between November 2022 and November 2024. Patients were randomly allocated into a modeling group (n = 206) and a validation group (n = 88). Based on the diagnosis of OSAS, patients in each group were further categorized into OSAS and non-OSAS subgroups. Logistic regression analysis was employed to identify independent risk factors for OSAS. R software was utilized to construct the nomogram. The model's discrimination was assessed using the Receiver Operating Characteristic (ROC) curve and Area Under the Curve (AUC). Calibration was evaluated using the Hosmer-Lemeshow (H-L) test. Decision Curve Analysis (DCA) was performed to determine the clinical utility of the nomogram.

RESULTS

Among the 294 patients, 89 (30.27 %) were diagnosed with OSAS. Within the modeling group (n = 206), 62 children (30.10 %) developed OSAS. Multivariate logistic regression analysis identified obesity, neck circumference, neck circumference-to-height ratio, tonsillar hypertrophy, adenoid hypertrophy, and a history of rhinitis/sinusitis as significant independent risk factors for OSAS (P < 0.05). The nomogram demonstrated excellent discrimination with an AUC of 0.964 in the modeling group and 0.967 in the validation group. Good calibration was confirmed by the H-L test in both the modeling group (x2 = 7.045, P = 0.722) and the validation group (x2 = 7.045, P = 0.725). DCA indicated that the nomogram provided substantial clinical net benefit across a wide range of threshold probabilities (approximately 0.10-0.95) for predicting OSAS in snoring children.

CONCLUSION

Obesity, neck circumference, neck circumference-to-height ratio, tonsillar hypertrophy, adenoid hypertrophy, and a history of rhinitis/sinusitis are significant predictors of OSAS in snoring children. The nomogram developed based on these factors serves as a reliable and clinically applicable tool for predicting the individual risk of OSAS in this population.