Diagnosis and management of childhood obstructive sleep apnea syndrome

Carole L. Marcus, Lee Jay Brooks, Kari A. Draper, David Gozal, Ann Carol Halbower, Jacqueline Jones, Michael S. Schechter, Stephen Howard Sheldon, Karen Spruyt, Sally Davidson Ward, Christopher Lehmann, Richard N. Shiffman

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: This revised clinical practice guideline, intended for use by primary care clinicians, provides recommendations for the diagnosis and management of the obstructive sleep apnea syndrome (OSAS) in children and adolescents. This practice guideline focuses on uncomplicated childhood OSAS, that is, OSAS associated with adenotonsillar hypertrophy and/or obesity in an otherwise healthy child who is being treated in the primary care setting. METHODS: Of 3166 articles from 1999-2010, 350 provided relevant data. Most articles were level II-IV. The resulting evidence report was used to formulate recommendations. RESULTS AND CONCLUSIONS: The following recommendations are made. (1) All children/adolescents should be screened for snoring. (2) Polysomnography should be performed in children/adolescents with snoring and symptoms/signs of OSAS; if polysomnography is not available, then alternative diagnostic tests or referral to a specialist for more extensive evaluation may be considered. (3) Adenotonsillectomy is recommended as the first-line treatment of patients with adenotonsillar hypertrophy. (4) High-risk patients should be monitored as inpatients postoperatively. (5) Patients should be reevaluated postoperatively to determine whether further treatment is required. Objective testing should be performed in patients who are high risk or have persistent symptoms/signs of OSAS after therapy. (6) Continuous positive airway pressure is recommended as treatment if adenotonsillectomy is not performed or if OSAS persists postoperatively. (7) Weight loss is recommended in addition to other therapy in patients who are overweight or obese. (8) Intranasal corticosteroids are an option for children with mild OSAS in whom adenotonsillectomy is contraindicated or for mild postoperative OSAS.

Original languageEnglish (US)
Pages (from-to)576-584
Number of pages9
JournalPediatrics
Volume130
Issue number3
DOIs
StatePublished - Sep 2012
Externally publishedYes

Fingerprint

Obstructive Sleep Apnea
Snoring
Polysomnography
Practice Guidelines
Hypertrophy
Signs and Symptoms
Primary Health Care
Therapeutics
Continuous Positive Airway Pressure
Sleep
Syndrome
Childhood
Routine Diagnostic Tests
Weight Loss
Inpatients
Adrenal Cortex Hormones
Referral and Consultation
Obesity

Keywords

  • Adenotonsillectomy
  • Continuous positive airway pressure
  • Sleep-disordered breathing
  • Snoring

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Marcus, C. L., Brooks, L. J., Draper, K. A., Gozal, D., Halbower, A. C., Jones, J., ... Shiffman, R. N. (2012). Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 130(3), 576-584. https://doi.org/10.1542/peds.2012-1671

Diagnosis and management of childhood obstructive sleep apnea syndrome. / Marcus, Carole L.; Brooks, Lee Jay; Draper, Kari A.; Gozal, David; Halbower, Ann Carol; Jones, Jacqueline; Schechter, Michael S.; Sheldon, Stephen Howard; Spruyt, Karen; Ward, Sally Davidson; Lehmann, Christopher; Shiffman, Richard N.

In: Pediatrics, Vol. 130, No. 3, 09.2012, p. 576-584.

Research output: Contribution to journalArticle

Marcus, CL, Brooks, LJ, Draper, KA, Gozal, D, Halbower, AC, Jones, J, Schechter, MS, Sheldon, SH, Spruyt, K, Ward, SD, Lehmann, C & Shiffman, RN 2012, 'Diagnosis and management of childhood obstructive sleep apnea syndrome', Pediatrics, vol. 130, no. 3, pp. 576-584. https://doi.org/10.1542/peds.2012-1671
Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012 Sep;130(3):576-584. https://doi.org/10.1542/peds.2012-1671
Marcus, Carole L. ; Brooks, Lee Jay ; Draper, Kari A. ; Gozal, David ; Halbower, Ann Carol ; Jones, Jacqueline ; Schechter, Michael S. ; Sheldon, Stephen Howard ; Spruyt, Karen ; Ward, Sally Davidson ; Lehmann, Christopher ; Shiffman, Richard N. / Diagnosis and management of childhood obstructive sleep apnea syndrome. In: Pediatrics. 2012 ; Vol. 130, No. 3. pp. 576-584.
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