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Review
. 2013 Sep 25:5:109-23.
doi: 10.2147/NSS.S51907.

Obstructive sleep apnea in children: a critical update

Hui-Leng Tan  1 , David Gozal, Leila Kheirandish-Gozal
Affiliations
Review

Obstructive sleep apnea in children: a critical update

Hui-Leng Tan et al. Nat Sci Sleep. .

Abstract

Obstructive sleep apnea (OSA) in children is a highly prevalent disorder caused by a conglomeration of complex pathophysiological processes, leading to recurrent upper airway dysfunction during sleep. The clinical relevance of OSA resides in its association with significant morbidities that affect the cardiovascular, neurocognitive, and metabolic systems. The American Academy of Pediatrics recently reiterated its recommendations that children with symptoms and signs suggestive of OSA should be investigated with polysomnography (PSG), and treated accordingly. However, treatment decisions should not only be guided by PSG results, but should also integrate the magnitude of symptoms and the presence or absence of risk factors and signs of OSA morbidity. The first-line therapy in children with adenotonsillar hypertrophy is adenotonsillectomy, although there is increasing evidence that medical therapy, in the form of intranasal steroids or montelukast, may be considered in mild OSA. In this review, we delineate the major concepts regarding the pathophysiology of OSA, its morbidity, diagnosis, and treatment.

Keywords: adenotonsillar hypertrophy; morbidity; pathophysiology; pediatric sleep disordered breathing; polysomnography; treatment.

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Figures

Figure 1
Figure 1
Pathophysiological factors involved in pediatric OSA. Abbreviations: FRC, functional residual capacity; OSA, obstructive sleep apnea.
Figure 2
Figure 2
Morbidity of pediatric OSA. Abbreviations: BP, blood pressure; OSA, obstructive sleep apnea.
See this image and copyright information in PMC

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