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This study delineates phenotypic and polysomnographic differences in children with extreme versus very severe OSA, highlighting the critical role of obesity and oxygenation metrics in identifying extreme cases.
Preoperative cardiac testing in children with very severe OSA had low diagnostic yield and rarely changed management. Risk appeared highest in obese adolescents with AHI >50 events/hour.
The KATE trial (n=60) found no between-group difference in polysomnographic OAHI change after 3 years, though adenotonsillectomy improved disease-specific quality of life. Nearly 42% of watchful-waiting children later underwent surgery, sug