A 6-year-old child is evaluated for pediatric obstructive sleep apnea (OSA). Overnight polysomnography shows an apnea-hypopnea index (AHI) of 5 events/hour. According to current guidelines, this AHI value in a pediatric patient is classified as:

• A Normal (AHI <1 is abnormal in children)
• B Mild OSA
• C Severe OSA
• D Moderate OSA ✓

Explanation

In children, the AHI thresholds differ from adults: AHI ≥1 is abnormal; mild OSA is AHI 1–4.9; moderate OSA is AHI 5–9.9; severe OSA is AHI ≥10. An AHI of 5 in a 6-year-old therefore represents moderate pediatric OSA, warranting adenotonsillectomy as the first-line surgical treatment. Adult thresholds (mild <5, moderate 5–14, severe ≥15) should not be applied to children.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.