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Obstructive sleep apnea in children: a critical update

Hui-Leng Tan1, David Gozal, Leila Kheirandish-Gozal

  • 1Sections of Pediatric Sleep Medicine and Pediatric Pulmonology, Department of Pediatrics, Comer Children's Hospital, Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA ; Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK.

Nature and Science of Sleep
|October 11, 2013
PubMed

Insights

Obstructive sleep apnea (OSA) in children is common and affects multiple body systems. Treatment decisions for pediatric OSA require considering symptoms and comorbidities alongside polysomnography results.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Obstructive sleep apnea (OSA) is a prevalent pediatric disorder characterized by recurrent upper airway obstruction during sleep.
  • OSA is linked to significant cardiovascular, neurocognitive, and metabolic morbidities in children.
  • The American Academy of Pediatrics recommends polysomnography (PSG) for diagnosing suspected pediatric OSA.

Purpose of the Study:

  • To review the pathophysiology, morbidity, diagnosis, and treatment of pediatric obstructive sleep apnea.
  • To emphasize integrating clinical factors with PSG findings for treatment decisions.
  • To discuss current therapeutic strategies for pediatric OSA.

Main Methods:

  • This is a review article synthesizing current knowledge on pediatric OSA.
  • Key concepts regarding OSA pathophysiology, clinical impact, diagnostic criteria, and treatment options are discussed.
  • Evidence for both surgical and medical management is evaluated.

Main Results:

  • Pediatric OSA results from complex upper airway dysfunction during sleep.
  • Treatment decisions should incorporate symptom severity, risk factors, and evidence of morbidity.
  • Adenotonsillectomy is the primary treatment for hypertrophy-related OSA, with medical therapies like intranasal steroids or montelukast considered for mild cases.

Conclusions:

  • Effective management of pediatric OSA necessitates a comprehensive approach beyond PSG.
  • Early diagnosis and tailored treatment are crucial to mitigate long-term health consequences.
  • Further research into optimal treatment strategies for varying OSA severities is warranted.

Keywords:
adenotonsillar hypertrophymorbiditypathophysiologypediatric sleep disordered breathingpolysomnographytreatment

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