Approach to the Pediatric Patient with Sleep-Disordered Breathing

Sleep disordered breathing (SDB) is a commonly encountered medical problem in the pediatric patient population with varying ranges of severity including primary snoring, upper airway resistance syndrome and obstructive sleep apnea/hypopnea syndrome. While many clinicians are aware of certain risk factors that predispose children to obstructive sleep apnea syndrome, the prompt identification of all patients at risk for each of these syndromes is imperative. Clinicians currently use a combination of clinical indicators and polysomnographic data to diagnose children who may fall into the SDB spectrum. Without prompt diagnosis, a child be subject to multiple neurocognitive deficits, which may have been ameliorated by treatment. The appropriate treatment for obstructive sleep apnea hypopnea syndrome has traditionally been thought to be surgical, however, the ability to properly categorize children into the above spectrum of disorders will help a practitioner evaluate each patient individually and determine if surgery or other treatments are appropriate for a particular patient.

Keywords: Sleep disordered breathing, obstructive sleep apnea-hypopnea syndrome, upper airway resistance syndrome, snoring, polysomnogram, home sleep study, adenotonsillectomy.