Calculators & Tools

Apnoea–Hypopnoea Index (Paediatric OSA)

Severity of obstructive sleep apnoea in children - events per hour of sleep.

1 What is the Apnoea–Hypopnoea Index (Paediatric OSA)?

The Apnoea–Hypopnoea Index (Paediatric OSA) is a sleep scoring tool used in paediatric practice. Severity of obstructive sleep apnoea in children - events per hour of sleep. It scores 1 criteria and interprets the total across 4 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in sleep
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 1 criteria: AHI - obstructive apnoeas + hypopnoeas per hour of sleep. Totals are then banded: any score - Normal: aHI <1/hour is normal in children - note that the paediatric threshold is far lower than the adult cut-off of 5; 1 severity band or more - Mild OSA: aHI 1-4.9 - mild paediatric OSA. Consider adenotonsillectomy if adenotonsillar hypertrophy is present, or intranasal steroids/montelukast; reassess; 2 severity band or more - Moderate OSA: aHI 5-9.9 - moderate OSA. Adenotonsillectomy is usually first-line; arrange post-operative reassessment; 3 severity band or more - Severe OSA: aHI ≥10 - severe OSA. High peri-operative risk: plan inpatient post-operative monitoring; consider CPAP if surgery is unsuitable or residual disease persists.
  • Paediatric criteria differ from adults: an obstructive AHI ≥1/hour is already abnormal in a child.
  • Source: Marcus CL et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. AAP Clinical Practice Guideline. Pediatrics 2012;130:e714-55.

4 Frequently asked questions

How many criteria does the Apnoea–Hypopnoea Index (Paediatric OSA) use?

1. They are AHI - obstructive apnoeas + hypopnoeas per hour of sleep.

What do the bands of the Apnoea–Hypopnoea Index (Paediatric OSA) mean?

The total is interpreted as: any score - Normal: aHI <1/hour is normal in children - note that the paediatric threshold is far lower than the adult cut-off of 5; 1 severity band or more - Mild OSA: aHI 1-4.9 - mild paediatric OSA. Consider adenotonsillectomy if adenotonsillar hypertrophy is present, or intranasal steroids/montelukast; reassess; 2 severity band or more - Moderate OSA: aHI 5-9.9 - moderate OSA. Adenotonsillectomy is usually first-line; arrange post-operative reassessment; 3 severity band or more - Severe OSA: aHI ≥10 - severe OSA. High peri-operative risk: plan inpatient post-operative monitoring; consider CPAP if surgery is unsuitable or residual disease persists.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Paediatric criteria differ from adults: an obstructive AHI ≥1/hour is already abnormal in a child.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.