Obstructive Sleep Apnea in Children: Controversies in Diagnosis and Management

Abstract

ABSTRACT Aim: To discuss commonly encountered diagnostic and therapeutic dilemmas in pediatric obstructive sleep apnea (OSA). Background Pediatric OSA is a fairly common childhood disorder, affecting 1 to 5% of all children and much larger proportions of children with selected comorbidities. Untreated OSA is associated with deleterious effects on neurobehavioral outcomes, cardiovascular health, and growth. Results We discuss several important diagnostic dilemmas, including when to obtain a preoperative polysomnogram (PSG), the relationship between OSA and sleep-disordered breathing, and limitations of conventional PSG-derived metrics. Management challenges commonly encountered in clinical practice include defining surgical cure and providing reliable estimates for families preoperatively, issues related to the use of positive airway pressure, and emerging alternative and complementary therapeutic modalities. Conclusion While recently published clinical practice guidelines have provided important standards for the diagnosis and management of pediatric OSA, many areas of uncertainty remain. Clinical significance We provide a review of current diagnostic and therapeutic controversies relevant to the practicing clinician. How to cite this article Ingram DG, Friedman NR. Obstructive Sleep Apnea in Children: Controversies in Diagnosis and Management. Int J Head Neck Surg 2016;7(2):83-88.