A 5-year-old child is investigated for suspected obstructive sleep apnea. The gold standard diagnostic test and the apnea-hypopnea index (AHI) threshold for OSA diagnosis in children is:
- A Overnight polysomnography; AHI ≥1 event/hour ✓
- B Overnight polysomnography; AHI ≥5 events/hour
- C Home overnight oximetry; oxygen desaturation index ≥4%
- D Sleep questionnaire (PSQ-22); score >0.33
Correct answer: A. Overnight polysomnography; AHI ≥1 event/hour
Explanation
In children, the gold standard for diagnosing OSA is overnight attended polysomnography (PSG). Unlike adults (AHI ≥5), the diagnostic threshold in children is AHI ≥1 obstructive apnea/hypopnea event per hour of sleep, reflecting the greater vulnerability of the developing brain and cardiopulmonary system to even mild intermittent hypoxia. Adenotonsillectomy is first-line treatment in healthy children with OSA and tonsillar hypertrophy.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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