ERS statement on obstructive sleep disordered breathing in 1- to 23-month-old children

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Athanasios G Kaditis1, Maria Luz Alonso Alvarez2, An Boudewyns3

  • 1Paediatric Pulmonology Unit, First Dept of Paediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece kaditia@hotmail.com.

The European Respiratory Journal
|December 9, 2017
PubMed

Insights

Obstructive sleep disordered breathing (SDB) in infants requires objective assessment. Treatment of underlying causes, such as upper airway obstruction, is crucial for managing this multifactorial condition.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Obstructive sleep disordered breathing (SDB) is a significant concern in infants aged 1-23 months.
  • SDB can lead to serious comorbidities including pulmonary hypertension, growth delay, and behavioral issues.
  • Coexisting conditions like feeding difficulties and recurrent otitis media are common in infants with SDB.

Purpose of the Study:

  • To summarize current evidence and practice for diagnosing and managing obstructive SDB in infants (1-23 months).
  • To provide clinical guidance based on a systematic literature review.
  • To highlight the multifactorial nature of SDB in this age group.

Main Methods:

  • A systematic literature search was conducted, summarizing 159 relevant articles.
  • Clinical questions regarding SDB diagnosis and management in infants were addressed.
  • Objective measures like polysomnography, polygraphy, or nocturnal oximetry are recommended for severity assessment.

Main Results:

  • SDB is suspected based on symptoms or signs of upper airway obstruction.
  • Specific patient groups, including those with apparent obstruction, abnormal sleep studies, predisposing conditions (e.g., mandibular hypoplasia), and complex syndromes (e.g., Down syndrome), benefit from treatment.
  • Common treatments include adenotonsillectomy, continuous positive airway pressure (CPAP), and condition-specific interventions (e.g., supraglottoplasty, nasopharyngeal airway).

Conclusions:

  • Obstructive SDB in infants is a complex disorder requiring comprehensive evaluation.
  • Objective assessment is essential for accurate diagnosis and management planning.
  • Addressing all contributing factors to upper airway obstruction during sleep is key to effective treatment.

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