Update in obstructive sleep apnea syndrome in children

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Rev Bras Otorrinolaringol (Engl Ed). 2005 Jan-Feb;71(1):74-80.

Update in obstructive sleep apnea syndrome in children.

Balbani AP, Weber SA, Montovani JC.

Medical School of Botucatu, UNESP.

The prevalence of OSAS in children is 0.7-3%, with peak incidence in

pre-schoolers. It is characterised by partial or complete upper

airway obstruction during sleep, causing intermittent hypoxia. Both

anatomical (severe nasal obstruction, craniofacial anomalies,

hypertrophy of the pharyngeal lymphoid tissue, laryngeal anomalies,

etc.) and functional factors (neuromuscular diseases) predispose to

OSAS during childhood. The main cause of OSAS in children in

adenotonsillar hypertrophy. The most common clinical manifestations

of OSAS are: nocturnal snoring, respiratory pauses, restless sleep

and mouth breathing. Nocturnal pulse oximetry, nocturnal noise

audio/videotape recording and nap polysomnography are useful tools

for screening suspected cases of OSAS in children, and the gold-

standard for diagnosis is overnight polysomnography in the sleep

laboratory. On the contrary of SAOS adults, children usually present:

less arousals associated to apnea events, more numerous

apneas/hypopneas during REM sleep, and more significant oxyhemoglobin

desaturation even in short apneas. The treatment of OSAS may be

surgical (adenotonsillectomy, craniofacial abnormalities correction,

tracheostomy) or clinical (sleep hygiene, continuous positive airway

pressure--CPAP).