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Invited Commentary
May 28, 2020

Do Young Children With Nonsevere Obstructive Sleep Apnea Benefit From Adenotonsillectomy?The CHAT vs the KATE Study

Author Affiliations
  • 1Department of Otolaryngology Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, Virginia
  • 2Department of Pediatric Sleep Medicine, Children’s Hospital of the King’s Daughters, Norfolk, Virginia
JAMA Otolaryngol Head Neck Surg. 2020;146(7):654-655. doi:10.1001/jamaoto.2020.0878

Obstructive sleep apnea (OSA) in children is characterized by snoring, disrupted sleep, and daytime sequelae such as hyperactivity and poor behavior. The severity of OSA in children is classified according to the apnea–hypopnea index (AHI) on full-night polysomnography (PSG). Children with an AHI score greater than 1 or 2 and less then 10 are considered to have mild to moderate OSA (nonsevere disease). Traditionally, adenotonsillectomy has been the primary treatment for pediatric OSA. However, over the past several years controversy has emerged regarding the best management strategy for pediatric patients with nonsevere disease. Recent studies have shown that watchful waiting1 and therapy with anti-inflammatory medications2 are also effective treatments for children with mild to moderate OSA. Further research is needed to establish evidence-based treatment protocols for children with nonsevere OSA.

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