Pediatric Obstructive Sleep Apnea

Otolaryngol Clin North Am. 2016 Dec;49(6):1449-1464. doi: 10.1016/j.otc.2016.07.001.

Abstract

Screening for obstructive sleep apnea (OSA) with in-laboratory polysomnography is recommended for children with sleep disordered breathing. Adenotonsillectomy is the first-line therapy for pediatric OSA, although intranasal steroids and montelukast can be considered for those with mild OSA and continuous positive airway pressure for those with moderate to severe OSA awaiting surgery, poor surgical candidates or persistent OSA. Bony or soft tissue upper airway surgery is reasonable for children failing medical management or those with persistent OSA following adenotonsillectomy. Weight loss and oral appliance therapy are also useful. A multi-modality approach to diagnosis and treatment is preferred.

Keywords: Diagnosis; Management; Obstructive sleep apnea; Pediatric.

Publication types

  • Review

MeSH terms

  • Adenoidectomy
  • Administration, Intranasal
  • Anesthetics / administration & dosage
  • Child
  • Continuous Positive Airway Pressure
  • Endoscopy
  • Glucocorticoids
  • Humans
  • Magnetic Resonance Imaging, Cine
  • Medical History Taking
  • Nasal Obstruction / surgery
  • Oral Surgical Procedures
  • Orthodontic Appliances, Removable
  • Perioperative Care
  • Physical Examination
  • Polysomnography
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / therapy*
  • Tonsillectomy
  • Weight Loss

Substances

  • Anesthetics
  • Glucocorticoids