Childhood Obstructive Sleep Apnea: from Diagnosis to Therapy—an Update

Abstract

Obstructive sleep apnea syndrome (OSAS) is common in childhood and is characterized by recurrent upper airway obstructive events during sleep. It is associated with significant morbidity, potentially influencing long-term neurocognitive and behavioral development, as well as cardiovascular sequelae. Children differ from adults with respect to etiology, clinical presentation, and medical and surgical management. A comprehensive review article concerning the pathophysiology, diagnosis, and treatment of OSAS was undertaken. To date, OSAS is a very common problem in children and is primarily caused by adenotonsillar hypertrophy, and adenotonsillectomy remains the first-line surgical treatment. Clinical and epidemiological studies show that OSAS is a multifactorial and complex disease with a strong genetic basis. OSAS should be recognized as a public health problem due to the increasing incidence of this condition secondary to rising rates of obesity in children. It has a significant impact on the growth and development of a child from a behavioral and neurodevelopmental perspective. This is particularly important in children with secondary medical conditions. It is therefore a crucial tailored approach to pediatric OSAS patients in order to diagnose and treat early this condition with a multidisciplinary team including otolaryngology, respiratory medicine, pediatrics, and clinical nutrition services.