Algorithm for the diagnosis and treatment of pediatric OSA: a proposal of two pediatric sleep centers
Abstract
There is currently no consensus on the best method of managing of obstructive sleep apnea (OSA) in childhood. In the present paper, an algorithm for the diagnosis and treatment of the disorder is proposed. Sleep apnea is suspected when parents report relevant symptoms or when there are abnormalities that predispose to OSA such as adenotonsillar hypertrophy, obesity, craniofacial anomalies, or neuromuscular disorders. OSA-associated morbidity including elevated blood pressure, daytime sleepiness or learning problems, growth failure, and enuresis should be recognized. Severity of intermittent upper airway obstruction during sleep can be determined objectively by polysomnography or, if polysomnography is not available, by nocturnal pulse oximetry. Risk factors predicting persistence of OSA in adolescence (male gender, development of obesity) need to be identified. Children with moderate-to-severe OSA, or with mild OSA, but accompanied by morbidity, or by risk factors predicting persistence of the disorder should have priority for treatment. An individualized and multifaceted therapeutic approach which addresses in a step-by-step fashion all abnormalities that contribute to upper airway obstruction during sleep is necessary.
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Conditions such as obesity, adenoid hypertrophy, craniofacial abnormalities, and other factors could narrow the anatomic airway.
“Conditions such as obesity, adenoid hypertrophy, craniofacial abnormalities, and other factors could narrow the anatomic airway.31”
From Effectiveness of functional orthodontic appliances in obstructive sleep apnea treatment in children: literature review (2022) · cites this paper as [31]
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Katyal, V., Pamula, Y., Martin, A. J., Daynes, C. N., Kennedy, J. D., & Sampson, W. J. (2013) · American Journal of Orthodontics and Dentofacial Orthopedics · doi:10.1016/j.ajodo.2012.08.021 · Cited by 255 · see citing works
Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision
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Mandibular Advancement Appliances in Pediatric Obstructive Sleep Apnea: An Umbrella Review
Cozzi-Machado, C., Albertini, F. R., Silveira, S., & Machado-Júnior, A. J. (2023) · Sleep Science · doi:10.1055/s-0043-1776747 · Cited by 10 · see citing works
- Authors
- Kaditis, A., Kheirandish-Gozal, L., & Gozal, D.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Kaditis, Athanasios
- ORCID
- Kaditis, Athanasios
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 13
- Issue
- 3
- Pages
- 217-227
- ISSN
- 1389-9457 (ISSN-L)
- OpenAlex
- W2160059198
- Cited by
- 153
- References
- 139
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 10 · 2023: 11 · 2022: 5 · 2021: 16 · 2020: 15 · 2019: 5 · 2018: 5 · 2017: 11 · 2016: 10 · 2015: 21 · 2014: 14 · 2013: 12 · 2012: 6
- FWCI
- 1.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (HL-065270, HL-086662, K12-HL-090003, P50 HL-107160)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- pediatric obstructive sleep apnea, diagnostic algorithm, treatment algorithm, adenotonsillar hypertrophy, obesity, craniofacial anomalies, neuromuscular disorders, polysomnography, nocturnal oximetry, upper airway obstruction, personalized treatment
- MeSH terms
- Algorithms, Child, Child Health Services, Humans, Risk Factors, Polysomnography, Sleep Apnea, Obstructive
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