French consensus on the care pathway for children with suspected or diagnosed type 1 obstructive sleep disorder

Area of Science:

• Otorhinolaryngology
• Pediatric Sleep Medicine
• Respiratory Medicine

Background:

• Obstructive sleep-disordered breathing (OSDB) results from reduced upper airway size during sleep.
• Type 1 OSDB (OSA1) commonly affects young, non-obese children with ENT obstructions, such as enlarged tonsils or adenoids.
• While often associated with comorbidities in adults, pediatric OSA1 can occur without them.

Purpose of the Study:

• To outline the consensus recommendations for managing obstructive sleep apnea syndrome type 1 (OSA1) in children.
• To provide guidance for healthcare professionals involved in the diagnosis and treatment of pediatric OSA1.
• To emphasize the importance of a multidisciplinary approach in managing pediatric sleep-disordered breathing.

Main Methods:

• The study is based on collaborative work and recommendations from the French Society of Sleep Research and Medicine.
• Expert consensus was gathered from various specialists in pediatric sleep disorders.
• Diagnostic criteria include the presence of at least two nighttime symptoms, making a sleep study non-mandatory in some cases.
• A specialist otolaryngologist examination, including nasofibroscopy, is crucial for diagnosis.

Main Results:

• A sleep study is not mandatory for OSA1 diagnosis if two or more nighttime symptoms are present.
• Otolaryngological examination, including nasofibroscopy, is essential for diagnosis.
• The ENT specialist plays a primary role in initial care.

Conclusions:

• Management of pediatric OSA1 requires a multidisciplinary team including pediatricians, ENTs, orthodontists, and rehabilitation specialists.
• Continuous, multidisciplinary follow-up is essential to ensure treatment effectiveness and prevent recurrence.
• Restoration of nasal breathing is a key outcome of successful treatment.