Updated: February 21, 2026
Understanding the clinical differences between pediatric and adult sleep architecture is critical for accurate diagnosis. While an Apnea-Hypopnea Index (AHI) of 4 might be considered normal for a 40-year-old, it indicates mild-to-moderate sleep apnea in a child. This guide provides the current 2026 clinical thresholds for Sleep-Disordered Breathing (SDB) and normative sleep data across the lifespan.
OSA Severity Comparison (AHI)
The Apnea-Hypopnea Index (AHI) measures the number of pauses in breathing per hour of sleep. Pediatric thresholds are significantly stricter due to the impact of even mild hypoxia on the developing brain.
| Severity Level | Pediatric AHI (< 18 yrs) | Adult AHI (18+ yrs) |
|---|---|---|
| Normal | < 1 event/hr | < 5 events/hr |
| Mild | 1 – 5 events/hr | 5 – 14.9 events/hr |
| Moderate | 6 – 10 events/hr | 15 – 29.9 events/hr |
| Severe | > 10 events/hr | ≥ 30 events/hr |
Recommended Sleep Duration by Age
| Age Group | Recommended Duration | Normal Sleep Efficiency (SE) |
|---|---|---|
| Newborn (0–3 Months) | 14–17 hours | ≥ 85% |
| Infant (4–11 Months) | 12–15 hours | ≥ 85% |
| Toddler (1–2 Years) | 11–14 hours | ≥ 85% |
| Preschool (3–5 Years) | 10–13 hours | ≥ 85% |
| School-Age (6–13 Years) | 9–11 hours | ≥ 85% |
| Teenager (14–17 Years) | 8–10 hours | ≥ 85% |
| Adult (18–64 Years) | 7–9 hours | ≥ 80% |
| Older Adult (65+ Years) | 7–8 hours | ≥ 70% |
Quick Diagnostic Calculators
Clinical Practice Tips for 2026
- The Transition Gap: For patients aged 13-18, clinicians may use either Pediatric or Adult scoring rules. However, Adult rules are typically preferred for adolescents with adult-like physiques or those who have completed puberty.
- Screening Tools: Prioritize high-risk patients using the STOP-BANG (Score ≥3) for adults and the Pediatric Sleep Questionnaire (PSQ) (Score >0.33) for children.
- Oxygen Saturation: A normal Oxygen Desaturation Index (ODI) is typically < 5 in adults. In children, any significant desaturation below 92% warrants clinical investigation.
- Deep Sleep (N3) Trends: Pediatric patients should spend 25–35% of the night in N3 sleep. This declines naturally to < 10% in seniors; a total lack of N3 in children is a major red flag for sleep fragmentation.
- The "Sleepmaxxing" Trend: Monitor patients for orthosomnia—anxiety driven by wearable tech data that may paradoxically worsen sleep efficiency despite healthy AHI levels.
Sources & Methodology:
- American Academy of Sleep Medicine (AASM) Scoring Manual Version 3 (2024-2026 update).
- National Sleep Foundation (NSF) 2025-2026 Sleep Duration Guidelines.
- Journal of Clinical Sleep Medicine (JCSM): "Normative Sleep Values Across the Lifespan."
- International Classification of Sleep Disorders (ICSD-3-TR).
Disclaimer: This chart is for educational purposes for healthcare professionals and caregivers. It does not replace clinical judgment or a formal sleep study (PSG) interpretation by a board-certified sleep specialist.