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[Obstructive sleep apnea syndrome in children: the responsibility of pediatricians]
E Verrillo1, R Cilveti Portillo, E Estivill Sancho
1Departamento de Scienze Neurologiche e Psichiatriche dell' età infantile. Centro per i disturbi del Sonno in età Pediatrica. Università di Roma La Sapienza. Roma. Italy.
Insights
Obstructive sleep apnea syndrome (OSAS) in children is common and treatable. Early detection by pediatricians is crucial for managing this respiratory disorder and preventing complications like growth issues and hyperactivity.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Child Health
Background:
- Obstructive sleep apnea syndrome (OSAS) is a frequent pediatric respiratory disorder affecting 1-3% of children.
- It can lead to serious cardiopulmonary complications, growth retardation, hyperactivity, and learning difficulties.
- Early detection and treatment are vital for positive outcomes.
Purpose of the Study:
- To review current evidence on the clinical features, etiology, complications, and treatment of childhood OSAS.
- To emphasize the critical role of pediatricians in early OSAS detection, particularly in snoring children.
- To provide a clinical practice guideline for diagnosis and treatment.
Main Methods:
- Review of up-to-date evidence on childhood OSAS.
- Nocturnal polysomnography as the gold standard for diagnosis and severity quantification.
- Adenotonsillectomy as the primary treatment modality.
Main Results:
- OSAS diagnosis is reliable, and treatment is highly effective.
- Adenotonsillectomy has a success rate exceeding 85% in children.
- Early intervention can mitigate significant health risks.
Conclusions:
- Pediatricians must be vigilant for OSAS in children who snore.
- Prompt diagnosis via polysomnography and timely adenotonsillectomy are key.
- Effective management of OSAS improves children's health and development.
Abstract:
Although obstructive sleep apnea syndrome (OSAS) in children is a frequent and potentially serious respiratory disorder, it has a reliable diagnosis and treatment is highly effective. OSAS is a respiratory sleep-related disorder that forms part of sleep apnea-hypoapnea syndrome. The syndrome affects between 1 % and 3 % of children. In addition to its cardiopulmonary complications, it can retard growth and increase the risk of hyperactivity and learning difficulties. It has also been associated with attention deficit disorder and hyperactivity. When OSAS is suspected, up-to-date nocturnal polysomnography is the gold standard for the diagnosis and quantification of severity of childhood OSAS. In most children the treatment of choice is adenotonsillectomy, which has a success rate of more than 85 %. We provide an up-to-date review of the evidence on the clinical features, etiology, complications and treatment of OSAS in children. The main objective of this review is to alert pediatricians to their essential role in the early detection of this syndrome, especially among children who snore, and to provide a clinical practice guideline for the diagnosis and definitive treatment of these children.