Hanyang Med Rev HMR Hanyang Medical Reviews 1738-429X 2234-4446 Hanyang University School of Medicine 10.7599/hmr.2013.33.4.246 Review Article Obstructive Sleep Apnea Syndrome in Children Oh Jeong In Lee Seung Hoon Division of Rhinology & Sleep Medicine, Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. Correspondence to: Seung Hoon Lee. Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan 425-707, Korea. Tel: +82-31-412-5170, Fax: +82-31-412-5174, shleeent@korea.ac.kr 11 2013 25 11 2013 33 4 246 252 27 08 2013 07 10 2013 16 10 2013 © 2013 Hanyang University College of Medicine 2013 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Obstructive sleep apnea is characterized by partial or complete upper airway obstruction which leads to reduction of blood oxygenation often accompanied by frequent arousal during sleep. Obstructive sleep apnea in children has many different clinical features, compared with adults. In children, obstructive sleep apnea is mainly caused by enlarged tonsils and adenoids. Other conditions such as obesity, craniofacial abnormality, and neuromuscular disease are also relevant predisposing factors. Pediatric obstructive sleep apnea is associated with various secondary sequelae such as cognitive dysfunction, behavioral problem, attention deficit, reduced sleep-related quality of life and so on. The objective diagnostic test, standard polysomnograhy is often needed to diagnose and stratify the severity of obstructive sleep apnea, because subjective symptoms and signs related to obstructive sleep apnea are not always consistent with the severity of respiratory disturbance. Childhood obstructive sleep apnea should be diagnosed and treated, if clinically suspected, because various symptoms, signs and consequences can be improved with proper management. Adenotonsillectomy is the first-line treatment modality in pediatric obstructive sleep apnea with adenotonsillar hypertrophy. In addition, continuous positive airway pressure, rapid maxillary expansion, weight control, topical steroids, and antileukotrienes may be considered as adjuvant treatment options.

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Characteristics in clinical features, diagnosis and management in children with obstructive sleep apnea syndrome, when compared to adults with obstructive sleep apnea syndrome

REM, rapid eye movements; OSA, obstructive sleep apnea; AHI, apnea hypopnea index; T&A, tonsillectomy and adenoidectomy; UPPP, uvulopalatopharyngoplasty; CPAP, continuous positive airway pressure.

Indications of preoperative polysomnography in children with clinically suspected sleep-disordered breathing

SDB, sleep-disordered breathing.