A 6-year-old child undergoes overnight polysomnography for suspected obstructive sleep apnoea. The apnoea-hypopnoea index (AHI) returns as 3 events/hour. According to paediatric OSA diagnostic thresholds, this result represents:

• A Normal study — no OSA
• B Moderate OSA — CPAP mandatory before surgery
• C Severe OSA — immediate hospital admission required
• D Mild OSA — consider adenotonsillectomy if symptomatic ✓

Explanation

In children, paediatric OSA thresholds differ from adults: AHI ≥1 event/hour is abnormal (unlike adults where ≥5 is the threshold). Mild = 1–5 events/hour; moderate = 5–10; severe = >10 events/hour. An AHI of 3/hour in a symptomatic child constitutes mild OSA. Adenotonsillectomy is the first-line surgical intervention in children with OSA and adenotonsillar hypertrophy.

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

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Written and medically reviewed by the StethoPrep medical team.