pulmonary disorders
Obstructive Sleep Apnea (OSA) in Children
Treatment of OSA in Children
Adenotonsillectomy or correction of congenital micrognathia CPAP and/or weight loss with intensive support Adenotonsillectomyis usually effective in children with obstructive sleep apnea who are otherwise healthy and have enlarged tonsils and/or adenoids. Adenoidectomy alone is often ineffective. The risk of perioperative airway obstruction is higher among children with OSA than among children without OSA who undergo adenotonsillectomy; thus, close monitoring is important. For children who are not otherwise healthy, who have complex anatomic abnormalities or genetic conditions altering respiratory control, or who have cardiopulmonary complications, a physician experienced in management of OSA in children should be consulted. Adenotonsillectomy may be effective or may provide some relief ( Treatment reference ). Depending on the anatomic abnormality causing OSA, an alternate surgical procedure may be indicated (eg, Continuous positive airway pressure (CPAP)can be used for children who are not candidates for corrective surgery or who continue to have OSA after adenotonsillectomy. Because obesity in children is a risk factor for OSA,weight losscan decrease OSA severity in children with obesity and has other health benefits but is rarely sufficient treatment for OSA as monotherapy in the long term. Nocturnal oxygen supplementationmay help prevent hypoxemia until definitive treatment can be accomplished. Treatment of allergic rhinitis should be intensive. Corticosteroids and antibiotics are not usually indicated. 1.Bitners AC, Arens R: Evaluation and management of children with obstructive sleep apnea syndrome.Lung198(2):257-270, 2020. doi:10.1007/s00408-020-00342-5 