Normal polysomnography parameters in healthy children: a systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: Not specified in abstract

• Effect Size: Age-related decreases in TST, N3 sleep, REM sleep, arousals, and AHI; increases in N2 sleep and awakenings

• Primary Outcome: Normative values for 34 polysomnographic parameters in healthy children

• Nnt Or Sensitivity: Sleep latency showed sex difference of -1.27 minutes per 10% increase in male proportion

• Confidence Interval: 95% confidence intervals provided for all pooled estimates

Clinical Application

Highly feasible - provides reference standards for existing clinical practice Directly applicable to Australian paediatric sleep centres; supports RACGP guidelines for sleep disorder assessment in children Healthy children and adolescents requiring polysomnographic evaluation

Abstract

INTRODUCTION: There is a lack of normative values for polysomnographic parameters in childhood. This study presents a comprehensive meta-analysis of paediatric polysomnography parameters scored using recent criteria to establish normative values adjusted for age and sex. METHODOLOGY: A systematic search was conducted in Web of Science and Scopus for studies that performed overnight polysomnography in healthy children and reported polysomnographic parameters scored using the American Academy of Sleep Medicine criteria (2007 or 2012). Children with previously diagnosed health conditions were excluded. Estimates for sleep, arousals and cardiorespiratory parameters were pooled using a random-effects meta-analysis and the influence of sex and age was assessed using meta-regression. RESULTS: Of 3612 articles, 66 studies were eligible, resulting in a sample size of 2947 healthy children. Pooled estimates and 95% confidence intervals for 34 polysomnographic parameters were established. Meta-regression revealed age-related decrease in total sleep time (TST), sleep period time, TST in stage N3 and REM, number of sleep cycles, total arousals, total leg movements, periodic leg movement index, central apnoea index, apnoea-hypopnoea index (AHI), mean peripheral oxygen saturation (S pO2 ), mean heart rate in sleep and REM, while the number of awakenings, TST in stage N2, number of stage shifts, and S pO2 nadir increased with age. Sleep latency was the only parameter influenced by sex (change of -1.27 min per 10% increase in the proportion of males). CONCLUSION: This meta-analysis provides normative polysomnographic data for the paediatric population that can be used as control values in both clinical and research context.

References

1. 1.Van Eyck, A., de Caen, G., Bokhaut, J., Blinder, H., Bouziotis, J., Katz, S. L., Kaditis, A., Verhulst, S., & Ersu, R. (2026). Normal polysomnography parameters in healthy children: a systematic review and meta-analysis. European Respiratory Review, 35(160), Article 0224-2025. https://doi.org/10.1183/16000617.0224-2025