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The use of systemic corticosteroids in children with obstructive sleep apnea syndrome

Background: local and systemic inflammatory markers and pro-inflammatory cytokines are increased in children with obstructive sleep apnea syndrome (OSAS). Thus, systemic or topical anti-inflammatory agents are used in the treatment of OSAS. Aim: we evaluated the treatment with a short course of systemic corticosteroids in children with severe OSAS and adenotonsillar hypertrophy before the surgery. Methods: twenty-three children with severe OSAS were recruited. All children were treated with intranasal beclomethasone spray and 12 children were treated also with oral bethametasone, 0.1 mg/kg per day for 5 days. Sleep clinical record (SCR) and pulsoximetry before and after 7 days and 21 days in all children. Outcome measures included SCR score, adenotonsillar size, and pulsoximetry measures. Results: SCR score (8.9±1.0 vs 7.1±0.8 p=0.0001) was reduced and mean (95.4±1.2 vs 98.0±0.9 % p =0.0001) and minimum oxygen saturation (89.0±2.6 vs 94±3.5 p=0.001) were improved only in children treated with oral corticosteroid, and the improvement persisted after 3 weeks (p Conclusions: These results suggest that a short course of oral bethametasone could be used in children with severe pediatric OSAS and adenotonsillar hypertrophy before the surgery.