Polysomnographic Profile and Clinical Phenotypes of Osa in Association with Residual Sleep Apnea in Children

Introduction: Residual obstructive sleep apnea (OSA) is defined as persistence of the AHI at ≥1 respiratory event per hour of sleep after otorhinolaryngology intervention in pediatric population. In terms of OSA phenotypes in children, we recognize the common, adult, and congenital phenotypes. Material and Methods: We studied 34 pediatric patients with OSA diagnosed by standard overnight polysomnography (PSG). Based on the results, all 34 patients were indicated for adenotonsillectomy (ATE). After 3 months, patients were invited to the sleep laboratory for second control PSG. These OSA patients were divided according to clinical phenotype into two groups: common phenotype and adult phenotype. Results: Residual OSA was diagnosed in 24 patients with a mean AHI 6.67 ± 9.17 after ATE procedure. Incidence of severe residual OSA was 17.6%; moderate residual OSA was 20.6%; mild residual OSA was 32.4%. Residual OSA in classic phenotype was present in eight patients (57.1%). In total, 16 patients with the adult phenotype of OSA (80.0%) were diagnosed with residual OSA. Prevalence was significantly higher in children with the adult phenotype (p < 0.001). Conclusions: We concluded that there is a higher risk of residual OSA in children with the adult phenotype. Phenotyping of children with OSA appears to be an important tool for further management and also in predicting the severity of residual OSA.