Paediatrics: how to manage obstructive sleep apnoea syndrome

Area of Science:

• Pediatric Pulmonology
• Sleep Medicine
• Otolaryngology

Background:

• Obstructive sleep apnoea syndrome (OSAS) is characterized by upper airway obstruction during sleep, impacting children's neurocognitive and cardiovascular health.
• Untreated pediatric OSAS can lead to significant developmental and physiological consequences.
• Recent years have seen the development of practice guidelines for OSAS evaluation and management.

Purpose of the Study:

• To provide a narrative review of current diagnostic and treatment strategies for pediatric OSAS.
• To discuss alternative diagnostic methods beyond polysomnography.
• To explore various therapeutic options and their applicability.

Main Methods:

• Narrative review of existing literature and practice guidelines.
• Discussion of diagnostic tools including polysomnography and alternatives.
• Analysis of current treatment modalities for pediatric OSAS.

Main Results:

• Adenotonsillectomy is the primary treatment but not universally effective.
• Positive airway pressure (PAP) ventilation is effective, especially for complex cases, but adherence is challenging in young children.
• Watchful waiting, anti-inflammatory drugs, weight reduction, orthodontic procedures, and myofunctional therapy are viable options for selected cases.

Conclusions:

• Effective management of pediatric OSAS necessitates a multidisciplinary team approach.
• Treatment selection depends on individual patient factors, severity, and comorbidities.
• Exploring alternative and gentler treatment options is crucial for improving patient outcomes and adherence.