Treatment of obstructive sleep apnea in children: do we really know how?

Abstract 

Obstructive sleep apnea syndrome (OSAS) is a frequent, albeit underdiagnosed problem in children. If left untreated, OSAS may lead to substantial morbidities affecting multiple target organs and systems. The immediate consequences of OSAS in children include behavioral disturbance and learning deficits, pulmonary hypertension, as well as compromised somatic growth. However, if not treated promptly and early in the course of the disease, OSAS may also impose long-term adverse effects on neurocognitive and cardiovascular function, thereby providing a strong rationale for effective treatment of this condition. This review provides a detailed description of the current treatment modalities for pediatric OSAS, and uncovers the potential limitations of the available data on these issues. Furthermore, we postulate that OSAS will persist relatively often after tonsillectomy and adenoidectomy, and that critical studies need to be conducted to identify such patients and refine the clinical management algorithm for pediatric OSAS.

Keywords: obstructive sleep apnea, tonsils, adenoids, upper airway, pharynx, snoring, hypertension, CPAP, corticosteroids

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• f1 Correspondence should be addressed to: David Gozal, M.D., Professor and Director, Kosair Children's Hospital Research Institute, Departments of Pediatrics, Pharmacology and Toxicology, University of Louisville School of Medicine, 570 S. Preston Street, Ste. 321, Louisville, KY 40202, USA. Tel: (502) 852 2323; Fax: (502) 852 2215; E-mail:david.gozal@louisville.edu