Medical Treatment of Obstructive Sleep Apnea in Children

Abstract

Obstructive sleep apnea (OSA) is characterized by recurrent complete or partial obstruction of the upper airway. The prevalence is 1–4% in children aged between 2 and 8 years and rising due to the increase in obesity rates in children. Although persistent OSA following adenotonsillectomy is usually associated with obesity and underlying complex disorders, it can also affect otherwise healthy children. Medical treatment strategies are frequently required when adenotonsillectomy is not indicated in children with OSA or if OSA is persistent following adenotonsillectomy. Positive airway pressure treatment is a very effective modality for persistent OSA in childhood; however, adherence rates are low. The aim of this review article is to summarize medical treatment options for OSA in children.

Clinical Application of Pediatric Sleep Endoscopy: An International Survey

“…These data confirm most of the evidence in the literature, suggesting that the first line of treatment for healthy pediatric OSA should be surgical adenotonsillectomy [15][16][17][18][19][20][21][22][23][24][25].…”

“…In recent years, the use of DISE has gained popularity as a method for assessing the dynamic blockages in the upper airways that occur during sleep and guiding decisions regarding the treatment of OSA patients. Sleep surgeons globally using DISE and the notable progress in DISE-related studies have resulted in a growing body of literature agreeing on the effectiveness and application of DISE for adult OSA patients [15][16][17][18][19][20][21].…”

“…In addition, the available evidence showcasing its usefulness and efficiency is insufficient. The majority of literature regarding this subject is constituted by small case series or retrospective studies [17][18][19][20][21][22][23][24][25][26][27][28]. Despite evidence demonstrating that DISE impacts the decisions made regarding surgery in children, it remains unclear how many sleep doctors actually use this procedure and if the results from interventions guided by DISE surpass those from conventional methods.…”