Related Experiment Video

Updated: Sep 17, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

20.0K

Extreme pediatric obstructive sleep Apnea: Clinical Features, management, long-term outcomes and mortality

Kantisa Sirianansopa1, Colin Massicotte2, Sundeep Bola3

  • 1Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Canada; Division of Pulmonary and Critical Care Medicine, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Thailand.

Sleep Medicine
|July 1, 2025
PubMed

Insights

Extreme obstructive sleep apnea (OSA) in children presents significant challenges. Early identification and multidisciplinary care are crucial for managing this severe condition and improving patient outcomes.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Extreme obstructive sleep apnea (OSA), defined by an obstructive apnea-hypopnea index (OAHI) ≥100 events/hr, poses significant management challenges in pediatric patients.
  • The severity of extreme OSA is often associated with serious comorbidities, necessitating specialized clinical attention.

Purpose of the Study:

  • To review the clinical characteristics of pediatric patients diagnosed with extreme OSA.
  • To analyze the management strategies employed for extreme OSA in children.
  • To evaluate the outcomes and identify factors influencing prognosis in this patient population.

Main Methods:

  • Retrospective review of pediatric patients (≤18 years) with extreme OSA who underwent polysomnography (PSG) between 2010 and 2024.
  • Logistic regression analysis to identify factors associated with surgical management, residual OSA, and revision surgery.
  • Kaplan-Meier analysis to estimate 5-year mortality rates.

Main Results:

  • Fifty patients were analyzed, with a median age of 4.9 years; 64% were male. Median OAHI was 123.2 events/hour with a median nadir SpO2 of 65.5%.
  • Residual OSA was observed in 77.8% of patients post-initial surgery. Factors associated with outcomes included BMI Z-score < -2 for surgical management, nadir SpO2 ≤ 60% for residual OSA, and prolonged time with SpO2 < 90% for revision surgery.
  • The 5-year mortality rate was 8%, with higher mortality in children ≤2 years and those with craniofacial anomalies or laryngomalacia.

Conclusions:

  • Vigilant care and early identification of high-risk pediatric patients with extreme OSA are essential.
  • Multidisciplinary follow-up is critical for optimizing management and improving outcomes in children with extreme OSA.
Abstract

Keywords:
Extreme pediatric obstructive sleep apneaOSA mortalityObstructive apnea-hypopnea index (OAHI) ≥ 100/hrSurgical and respiratory management

More Related Videos

Author Spotlight: Traditional Chinese Medicine for Sleep Disorders in Acute COPD &#8212; A Safe, Cost-Effective Approach04:53

Author Spotlight: Traditional Chinese Medicine for Sleep Disorders in Acute COPD — A Safe, Cost-Effective Approach

Published on: October 18, 2024

914
Author Spotlight: Utilizing Traditional Chinese Acupuncture of the Ear to Improve Sleep Disorders05:34

Author Spotlight: Utilizing Traditional Chinese Acupuncture of the Ear to Improve Sleep Disorders

Published on: August 18, 2023

2.5K

Related Concept Videos

Sleep Apnea01:21

Sleep Apnea

Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
225
Chronic Obstructive Pulmonary Disease-V: Management01:29

Chronic Obstructive Pulmonary Disease-V: Management

Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
2.7K
Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary Resuscitation II: ACLS Airway Management

Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
112
Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
335
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
91
COPD: Pathogenesis and Clinical Features01:20

COPD: Pathogenesis and Clinical Features

Chronic obstructive pulmonary disease (COPD) is a group of lung conditions that progressively worsen over time, including chronic bronchitis and emphysema. This cluster of diseases collectively leads to a gradual and irreversible decline in lung function over time.
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
535