ABSTRACT
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common sleep disorder in adults
that is increasingly recognized in children, affecting 1 to 3% of children. Children
experience a spectrum of severity related to the degree of upper airway obstruction,
the duration of the disease, and the presence or absence of hypoxemic episodes. Failure
to diagnose and treat OSAHS can result in serious, but generally reversible consequences
for the child including impaired growth, neurocognitive and behavioral dysfunction,
and cardiorespiratory failure. Even mild OSAHS appears linked to reversible health
consequences. Adenotonsillar hypertrophy is the major predisposing factor for OSAHS
in childhood. However, enlarged tonsils and adenoids can be a normal finding in young
children and are not diagnostic for OSAHS. The identification of children with OSAHS
is often difficult because affected children may have no signs or symptoms when awake.
Furthermore, clinical assessment cannot reliably distinguish between simple snoring
and OSAHS. Adenotonsillectomy is the most common therapy for OSAHS in children, but
surprisingly, only a small percentage of children undergo any diagnostic testing prior
to surgery. Thus, the challenge is to develop new diagnostic strategies that effectively
screen, identify, and treat children most likely to benefit from specific treatment.
KEYWORD
obstructive sleep apnea - pediatrics - diagnostic criteria