Obstructive sleep apnea syndrome in children as a multi-disciplinary problem (a review)

Abstract

Aim. To analyze the data of modern scientific literature about the etiology, risk factors, pathogenesis, diagnosis and treatment of obstructive sleep apnea (OSA) in children. Results. The prevalence of OSA in children is about 1–5 %, with a peak incidence between the ages of 2 and 6 years. The main risk factors for OSA include adenotonsillar hypertrophy, obesity, and craniofacial anomalies. Nocturnal and daytime symptoms are clinically distinguished. Nocturnal ones include snoring, mouth breathing, pauses in breathing, restless sleep, enuresis and sweating; daytime symptoms are nasal obstruction, mouth breathing, morning headache, drowsiness, violation in attention concentration and hyperactivity. Nocturnal polysomnography is the gold standard for the diagnosis of OSA, in the absence of which the use of screening systems is possible, in particular – cardiorespiratory monitoring. The apnea/hypopnea index ≥1 per hour is considered a diagnostic criterion for mild OSA in children and differs from that in adults ≥5. Among the most effective treatments for OSA are adenoidectomy, CPAP therapy, intranasal corticosteroids, leukotriene receptor antagonists, and lifestyle modification in obesity is obvious. Conclusions. The problem of OSA syndrome is underestimated, and the vigilance of physicians as well as diagnostic opportunities of treatment and prevention facilities in Ukraine are quite low. Nocturnal polysomnography or screening diagnostic methods (cardiorespiratory monitoring) should be used in case of suspected OSA. Therapeutic measures for apnea are primarily aimed at eliminating etiological and risk factors. The presence of OSA in children with adenoids is an absolute indication for their removal.