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Introduction The gold standard of paediatric Obstructive Sleep Apnoea Syndrome (OSAS) diagnosis is overnight polysomnography (PSG). Current validated screening methods for paediatric OSAS are limited. Increasingly, parents present video clips which capture behaviours indicative of OSAS. We aimed to compare the diagnostic accuracy of a standardised sleep video analysis tool (Videosomnography Analysis for Paediatric Sleep apnoea (VAPS)) against PSG for paediatric OSAS.Methods 111 children, 2–12 years old referred for suspected OSAS underwent In-Lab PSG. Parents recorded 2 one-minute videos of their child’s sleep during PSG, and for two nights at home post-PSG. Videos were scored for the presence of 9 behaviours indicative of OSAS. PSG was scored independently and compared to VAPS scores.Results Total VAPS score had good discriminatory ability between PSG-diagnosed clinically non-significant (n=63) and clinically significant (n=48) OSAS, with an area under the ROC curve of 81.99%. Scores of ≥3 had a sensitivity of 91.67% and scores of ≥7 had a specificity of 88.89%. The area under the ROC curve rose to 85.45% when parents confirmed they were able to capture their child’s worst breathing. For this subset, VAPS score of ≥3 had a sensitivity of 96.43% and scores ≥7 had a specificity of 88.89%.Conclusions VAPS score may be useful in triaging patients suspected of paediatric OSAS to the appropriate physiological sleep investigations or treatment options where a Score of ≤2 is considered low risk, 3–6 medium risk, and ≥7 high risk, for paediatric OSAS.