Abstract
Obstructive sleep apnea syndrome (OSAS) is a common problem in children that may go unrecognized for several years. Although severe sequelae of OSAS may occur such as cor pulmonale and right-sided heart failure, the more common problems seen with OSAS are behavioral, including irritability, mood disturbances, inattentiveness, and daytime somnolence. Recent evidence suggests the potential for sustained adverse neurocognitive outcomes in snoring children. Most children with sleep apnea present with snoring, restless sleep, apneic spells, and have adenotonsillar hypertrophy. The diagnosis of OSAS is most accurately made by polysomnography, although overnight video or audio recording or pulse oximetry may be helpful. Nonsurgical treatment of OSAS includes the use of nasal steroids, oxygen, and continuous positive airway pressure or bilevel continuous positive airway pressure. The most common surgical treatment remains tonsillectomy and adenoidectomy, which is successful in resolving symptoms and physiologic changes due to OSAS. Alternatives include the use of radiofrequency or laser ablation of tissue, tongue suspension procedures, and skeletal surgery. Careful postoperative monitoring for complications is important in children with severe OSAS.
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