Turkish Journal of Medical Sciences




Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder in children. Determination of riskfactors for the development of OSA is essential for early diagnosis and treatment of the disease and decreases the risk of negativeconsequences. This study aimed to investigate the predictive values of Mallampati score, tonsillar size, and BMI z-score in the presenceand severity of OSA in children.Materials and methods: This prospective cross-sectional study included 114 children with OSA symptoms. All children were assessedby BMI z-score, Mallampati score, and tonsillar size and underwent overnight polysomnography. They were consecutively selected andassigned to 4 groups as follows: Group 1 included normal-weight with a low Mallampati score; Group 2 involved normal-weight with ahigh Mallampati score; Group 3 included obese with a low Mallampati score; and Group 4 involved obese with a high Mallampati score.Results: Of the 114 included children, 58 were female and 56 were male, with a mean age of 13.1 ± 2.9 years. OSA frequency andapnea-hypopnea index were significantly higher in group 4 compared with other groups (p = 0.003 and p < 0.0001, respectively),whereas average and minimum spO2 were significantly lower (for both, p = 0.001). Mallampati score and BMI z-score were found tobe significant for predicting OSA (odds ratio = 4.147, 95% CI: 1.440–11.944; p = 0.008 and odds ratio = 1.760, 95% CI: 1.039–2.980;p = 0.035, respectively). Among OSA patients, the Mallampati score, tonsillar size, and BMI z-score were found to be significant forpredicting OSA severity (odds ratio = 4.520, 95% CI: 1.332–15.335, p = 0.015, odds ratio = 9.177, 95% CI: 2.513–33.514, p = 0.001, andodds ratio = 2.820, 95% CI: 1.444–5.508; p = 0.002, respectively).Conclusion: The coexistence of the Mallampati score and BMI z-score significantly increases the presence of OSA in children.Mallampati score, tonsillar size, and BMI z-score are promising parameters for predicting OSA severity.


Children, obstructive sleep apnea, Mallampati score, BMI z-score, tonsillar size

First Page


Last Page