Management of obstructive sleep disordered breathing in 2 to 18 years old children from ERS perspective

Abstract

Sleep related breathing disorders in children and adolescents represent a new pathology both in terms of diagnostic mechanisms and therapeutic measures that are in a continuous multidisciplinary approach. Experts from the European Respiratory Society have tried to establish a guideline in the evaluation and management of children with obstructive sleep disorders (OSA). In this article we will address the pediatric population from 2 to 18 years old. OSA are defined by the presence of specific signs and symptoms of partial or complete obstruction of the upper airway, both of which occur during sleep. Polysomnography is considered the gold standard of SDB evaluation. Thus, an apnea:hypopnea index > 5 events / hour or an apnea:hypopnea index > 1 event / hour but in the presence of risk factors or associated comorbidities, requires specific treatments. Adenotonsillectomy remains the first line of treatment for OSA in children with adenotonsillar hypertrophy. Interventional measures are extremely varied. We can use oral therapeutic devices, noninvasive ventilation, drug therapy or surgery. Each interventional measure will be individualized in order to improve the quality of life of every patient. Our aim is to obtain clinical improvement or cure and to treat any complications that may appear over time. All these complex aspects bring together doctors from different specialties to provide patients with the most effective medical care services.

Keywords

• : sleep disordered breathing
• sleep apnea
• polysomnography
• noninvasive ventilation
• child