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Obstructive sleep apnea in children: update on the recognition, treatment and management of persistent disease

Hui-Leng Tan1, Leila Kheirandish-Gozal2, David Gozal2

  • 1a Department of Paediatric Respiratory Medicine , Royal Brompton Hospital , London , UK.

Expert Review of Respiratory Medicine
|March 8, 2016
PubMed

Insights

Adenotonsillectomy improves pediatric obstructive sleep apnea (OSA) but some children have persistent OSA. This review highlights risk factors and management strategies for persistent pediatric OSA post-adenotonsillectomy.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Adenotonsillectomy (AT) is the primary treatment for pediatric obstructive sleep apnea (OSA) due to adenotonsillar hypertrophy.
  • While AT improves OSA in most children, a notable percentage experience persistent OSA post-surgery.

Purpose of the Study:

  • To review recent research on persistent pediatric obstructive sleep apnea (OSA) after adenotonsillectomy (AT).
  • To propose a practical management approach for children with residual OSA post-AT.

Main Methods:

  • Literature review of recent studies on persistent pediatric OSA.
  • Analysis of risk factors associated with persistent OSA post-AT.
  • Development of a clinical management strategy.

Main Results:

  • Identified patient groups at higher risk for persistent OSA, including those with severe initial disease, older age, obesity, asthma, allergic rhinitis, Trisomy 21, craniofacial syndromes, or cerebral palsy.
  • Highlighted the need for continued monitoring and tailored management for at-risk pediatric OSA patients.

Conclusions:

  • Adenotonsillectomy is effective but not universally curative for pediatric OSA.
  • Identifying and managing risk factors is crucial for optimizing outcomes in children with persistent OSA post-AT.

Keywords:
CPAPadenotonsillectomydiagnosisinflammationsleep disordered breathingsleep studies

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