Features of Obstructive Sleep Apnea in Children with and without Comorbidities

To compare the clinical and polysomnographic features of obstructive sleep apnea (OSA) in children with adenotonsillar hypertrophy (Group A) and comorbidities (Group B). A five-year prospective study using nocturnal polysomnography before and after treatment. We included 168 patients: 121 in Group A and 47 in Group B, with differences in age (6.5 ± 3 vs. 8.6 ± 4 years; < 0.001), body mass index (BMI) (18 ± 4 vs. 20 ± 7 kg/m2; < 0.05), neck circumference (28 ± 4 vs. 30 ± 5 cm; < 0.05), and obesity (17% vs. 30%; < 0.05). Group B patients were more likely to have facial anomalies ( < 0.001), macroglossia ( < 0.01), dolichocephaly ( < 0.01), micrognathia ( < 0.001), and prognathism ( < 0.05). Adenotonsillectomy was performed in 103 Group A patients (85%) and 28 Group B patients (60%) ( < 0.001). In B, 13 children (28%) received treatment with continuous positive airway pressure (CPAP) and 2 (4%) with bilevel positive airway pressure (BiPAP), compared with 7 in Group A (6%) ( < 0.001). Maxillofacial surgery was more common in Group B ( < 0.01). Clinical and polysomnography parameters improved significantly in both groups after therapeutic intervention, though Group A showed better results. Obesity and facial anomalies are more frequent in childhood OSA patients with comorbidities, who often require combination therapy, such as ventilation and surgery.