Journal List > Hanyang Med Rev > v.33(4) > 1044169

Oh and Lee: Obstructive Sleep Apnea Syndrome in Children


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.

Figures and Tables

Table 1
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.

Table 2
Indications of preoperative polysomnography in children with clinically suspected sleep-disordered breathing

SDB, sleep-disordered breathing.


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