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Published on: December 6, 2016
Pediatric obstructive sleep apnea syndrome
Christian Guilleminault1, Ji Hyun Lee, Allison Chan
1Stanford University Sleep Disorders Program, Stanford, CA 94305, USA. cguil@stanford.edu
Insights
Pediatric obstructive sleep apnea syndrome (OSAS) involves various symptoms and syndromes. Early consideration of OSAS is crucial for affected children, with adenotonsillectomy and orthodontic treatments being key interventions.
Area of Science:
- Pediatric Sleep Medicine
- Otolaryngology
- Orthodontics
Background:
- Pediatric obstructive sleep apnea syndrome (OSAS) is a significant public health concern.
- Orthodontic and craniofacial abnormalities are often overlooked in pediatric OSAS.
- Polysomnography is essential for diagnosing sleep-disordered breathing.
Purpose of the Study:
- To review evidence-based knowledge on pediatric obstructive sleep apnea syndrome (OSAS).
- To highlight the importance of orthodontic and craniofacial factors in pediatric OSAS.
- To discuss current treatment options and their indications.
Main Methods:
- Systematic review of published articles on pediatric OSAS.
- Extraction of clinical symptoms, polysomnographic findings, and treatment data.
- Analysis of authors' recommendations for diagnosis and management.
Main Results:
- Adenotonsillectomy is a primary treatment, but patient selection is critical.
- Nasal continuous positive airway pressure is effective but requires patient and family cooperation.
- Orthodontic treatment is a valuable, often overlooked, complementary therapy for pediatric OSAS.
- Craniofacial abnormalities require careful assessment in pediatric OSAS patients.
Conclusions:
- Pediatric OSAS is associated with numerous symptoms and syndromes.
- Diagnosis of OSAS should be considered in children presenting with relevant symptoms.
- Integrated treatment approaches, including orthodontics, may improve outcomes for pediatric OSAS.
Objective:
To review evidence-based knowledge of pediatric obstructive sleep apnea syndrome (OSAS).
Data Sources And Extraction:
We reviewed published articles regarding pediatric OSAS; extracted the clinical symptoms, syndromes, polysomnographic findings and variables, and treatment options, and reviewed the authors' recommendations.
Data Synthesis:
Orthodontic and craniofacial abnormalities related to pediatric OSAS are commonly ignored, despite their impact on public health. One area of controversy involves the use of a respiratory disturbance index to define various abnormalities, but apneas and hypopneas are not the only abnormalities obtained on polysomnograms, which can be diagnostic for sleep-disordered breathing. Adenotonsillectomy is often considered the treatment of choice for pediatric OSAS. However, many clinicians may not discern which patient population is most appropriate for this type of intervention; the isolated finding of small tonsils is not sufficient to rule out the need for surgery. Nasal continuous positive airway pressure can be an effective treatment option, but it entails cooperation and training of the child and the family. A valid but often overlooked alternative, orthodontic treatment, may complement adenotonsillectomy.
Conclusions:
Many complaints and syndromes are associated with pediatric OSAS. This diagnosis should be considered in patients who report the presence of such symptoms and syndromes.
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