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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

Obstructive sleep apnea in children

James Chan1, Jennifer C Edman, Peter J Koltai

  • 1Department of Otolaryngology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

American Family Physician
|March 17, 2004
PubMed

Insights

Obstructive sleep apnea is common in children, often outgrown. Adenotonsillectomy is a curative treatment for most, but high-risk children require overnight monitoring post-surgery.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine

Background:

  • Obstructive sleep-disordered breathing affects 3-12% of children, with obstructive sleep apnea syndrome impacting 1-10%.
  • Many children with mild symptoms outgrow the condition.
  • Untreated obstructive sleep apnea can lead to failure to thrive, enuresis, attention-deficit disorder, behavioral issues, poor academic performance, and cardiopulmonary disease.

Purpose of the Study:

  • To review the diagnosis and management of obstructive sleep apnea in children.
  • To highlight the etiology, diagnostic standards, and treatment options for pediatric obstructive sleep apnea.

Main Methods:

  • Clinical diagnosis is reliable for obstructive sleep apnea.
  • Overnight polysomnography is the gold standard for evaluation.
  • Treatment options include continuous positive airway pressure, weight loss, and adenotonsillectomy.

Main Results:

  • Adenotonsillar hypertrophy is the most common cause of obstructive sleep apnea in children.
  • Continuous positive airway pressure and weight loss are poorly tolerated and not primary therapies.
  • Adenotonsillectomy is curative in the majority of pediatric patients.

Conclusions:

  • Adenotonsillectomy is the primary curative treatment for most children with obstructive sleep apnea.
  • Children with specific risk factors (craniofacial syndromes, neuromuscular diseases, comorbidities, severe OSA, younger than three years) face increased postoperative complications and require overnight hospital monitoring.

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