Skip to main content
AAO-HNSF 2026 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Scientific Oral Presentation

Pediatric Otolaryngology

Disparities in Access to Polysomnography and Treatment for Pediatric Obstructive Sleep Apnea

Monday, October 19, 2026
11:36 AM - 11:42 AM PT
Location: 409AB

    Presenting Author(s)

  • AD

    Abigail Doran, BS, BA

    Medical Student
    University of Arkansas for Medical Sciences
    Conway, Arkansas, United States

  • Ammar M. Hudefi, BS

    Medical Student
    University of Arkansas for Medical Sciences
    Little Rock, AR, United States

    • Co-Author(s)

  • IZ

    Isabella Zaniletti, PhD

    Biostatistician
    Children's Hospital Association, United States

  • KN

    Kenny Nguyen, MD, MEd

    ENT Clinical Research Fellow
    University of Arkansas for Medical Sciences
    Little Rock, Arkansas, United States

    • Senior Author(s)

  • Adrian Williamson, IV, MD

    Attending Physician
    University of Arkansas for Medical Sciences
    Little Rock, Arkansas, United States

Disclosure(s):
Adrian Williamson, MD, IV:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Pediatric obstructive sleep apnea (OSA) is associated with significant long-term morbidity when not treated. This study examined whether race/ethnicity, insurance status, and socioeconomic status are associated with disparities in access to polysomnography and subsequent surgical treatment.

Methods: We conducted a retrospective cohort study of children aged 2–18 years referred for diagnostic polysomnography (PSG) at a tertiary pediatric institution between January 2018 and January 2025, to evaluate the associations between sociodemographic factors with surgical treatment and timing. Analyses used logistic regression for surgery likelihood, and a gamma log linked model for time from PSG to surgery among treated children.

Results: A total of 3,701 children were included (median age 7 years [IQR, 3–12]; 55.4% male), and 936 (25.3%) underwent surgery. In multivariable analyses, higher AHI was associated with increased adjusted odds of surgery (aOR 1.02; 95% CI, 1.01–1.02; p< 0.001), while older age was associated with lower odds (aOR 0.94 per year; 95% CI, 0.93–0.96; p< 0.001). Obesity was independently associated with higher odds of surgery (aOR 1.43; 95% CI, 1.21–1.71; p< 0.001). Non-Hispanic Black children had higher adjusted odds of surgery compared with non-Hispanic White children (aOR 1.46; 95% CI, 1.21–1.76; p< 0.001). Insurance status and neighborhood income were not associated with surgery. Among children who underwent surgery, the median time from PSG to surgery was 182 days (IQR, 96–290). A 5-unit increase in AHI was associated with a 3% decrease in the mean time to surgery (adjusted mean ration aMR 0.97; 95% CI, 0.96-0.98; p< 0.001), while longer time from PSG order to completion was associated with longer time to surgery (aMR 1.02; 95% CI, 1.01, 1.02; p< 0.001).

Conclusions: OSA severity and obesity were the strongest predictors of surgical treatment and timing. Although insurance status and neighborhood income were not independently associated with delays in care, racial disparities in whether children underwent surgery persisted after adjustment.