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Review
. 2023 Jun 14;11(6):1708.
doi: 10.3390/biomedicines11061708.

Diagnosis and Treatment of Sleep Apnea in Children: A Future Perspective Is Needed

Esther Solano-Pérez  1   2 , Carlota Coso  1   2 , María Castillo-García  1   3   4 , Sofía Romero-Peralta  1   3   4 , Sonia Lopez-Monzoni  1 , Eduardo Laviña  1 , Irene Cano-Pumarega  2   5 , Manuel Sánchez-de-la-Torre  2   6   7 , Francisco García-Río  2   8   9   10 , Olga Mediano  1   2   3
Affiliations
Review

Diagnosis and Treatment of Sleep Apnea in Children: A Future Perspective Is Needed

Esther Solano-Pérez et al. Biomedicines. .

Abstract

Obstructive sleep apnea (OSA) in children is a prevalent, but still, today, underdiagnosed illness, which consists of repetitive episodes of upper airway obstruction during sleep with important repercussions for sleep quality. OSA has relevant consequences in the pediatric population, mainly in the metabolic, cardiovascular (CV), and neurological spheres. However, contrary to adults, advances in diagnostic and therapeutic management have been scarce in the last few years despite the increasing scientific evidence of the deleterious consequences of pediatric OSA. The problem of underdiagnosis and the lack of response to treatment in some groups make an update to the management of OSA in children necessary. Probably, the heterogeneity of OSA is not well represented by the classical clinical presentation and severity parameters (apnea/hypopnea index (AHI)), and new strategies are required. A specific and consensus definition should be established. Additionally, the role of simplified methods in the diagnosis algorithm should be considered. Finally, the search for new biomarkers for risk stratification is needed in this population. In conclusion, new paradigms based on personalized medicine should be implemented in this population.

Keywords: cardiovascular; children; diagnosis; hypoxic burden; sleep apnea; treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Differences in obstructive sleep apnea (OSA) between adults and children.
Figure 2
Figure 2
Etiology of pediatric OSA.
Figure 3
Figure 3
Mechanisms and consequences of OSA in children. Created with BioRender.com. This population is characterized by poor academic performance showing a reduction in memory capacities and difficulties in learning and attention (especially in specific areas such as mathematics, science, reading, and spelling) [24,25,26], which could be associated with hyperactive behavior during the day.
Figure 4
Figure 4
Recommended treatments depending on conditions leading to OSA in children. Abbreviations: OSA: obstructive sleep apnea; AHI: apnea/hypopnea index; CPAP: continuous positive airway pressure; BiPAP: bi-level positive airway pressure.
See this image and copyright information in PMC

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