Treatment of obstructive sleep apnea in children: Do we really know how?

Sleep Medicine Reviews

Volumn 7, Issue 1, 2003, Pages 61-80

  Lipton, Andrew J ^a   Gozal, David ^a  

^a University of Louisville School of Medicine   (United States)

Author keywords

Adenoids; Corticosteroids; CPAP; Hypertension; Obstructive sleep apnea; Pharynx; Snoring; Tonsils; Upper airway

Indexed keywords

ACETAZOLAMIDE; CORTICOSTEROID; FLUTICASONE; OPIATE ANTAGONIST; PREDNISONE; PROGESTERONE; PROTRIPTYLINE; STEROID; THEOPHYLLINE;

ADENOIDECTOMY; ALGORITHM; BEHAVIOR DISORDER; CARDIOVASCULAR FUNCTION; CHILD; CLINICAL TRIAL; COGNITIVE DEFECT; DIAGNOSTIC ERROR; HUMAN; HYPERTENSION; LEARNING DISORDER; OXYGEN THERAPY; POSITIVE END EXPIRATORY PRESSURE; PULMONARY HYPERTENSION; REVIEW; SLEEP APNEA SYNDROME; SNORING; TONSILLECTOMY;

EID: 0037313904     PISSN: 10870792     EISSN: None     Source Type: Journal    
DOI: 10.1053/smrv.2001.0256     Document Type: Review

References (100)

1. Ali NJ, Pitson D, Stradling JR. Snoring, sleep disturbance, and behaviour in 4-5 year olds. Arch Dis Child 1993; 68: 360-366.
2. Corbo GM, Fuciarelli F, Foresi A, De Benedetto F. Snoring in children: association with respiratory symptoms and passive smoking (published erratum appears in BMJ 1990; 300: 226.) BMJ 1989; 299: 1491-1494.
3. Owen GO, Canter RJ, Robinson A. Snoring, apnoea and ENT symptoms in the paediatric community. Clin Otolaryngol 1996; 21: 130-134.
4. Hulcrantz E, Löfstrand TB, Ahlquist RJ. The epidemiology of sleep related breathing disorders in children. Int J Pediatr Otorhinolaryngol 1995; Suppl 6: S63-S66.
5. Ferreira AM, Clemente V, Gozal D, Gomes A, Pissarra C, César H, Coelho I, Silva CF, Azevedo MHP. Snoring in Portuguese primary school children. Pediatrics 2000; 106(5): URL: http://www.pediatrics.org/cgi/content/full/106/5/e64
6. American Thoracic Society: Standards and indications for cardiopulmonary sleep studies in children. Am J Resp Crit Care Med 1996; 153: 866-878.
7. Marcus, CL, Omlin KJ, Basinski DJ, Bailey SL, Rachel AB, Keens TG, Davidson Ward SL. Normal polysomnographic values for children and adolescents. Am Rev Resp Dis 1992; 146: 1235-1239.
8. Goh DY, Galster P, Marcus CL. Sleep architecture and respiratory disturbances in children with obstructive sleep apnea. Am J Respir Crit Care Med 2000; 162: 682-686.
9. Bandla HPR, Gozal D. Dynamic changes in EEG spectra during obstructive apnea in children. Pediatr Pulmonol 2000; 29: 359-365.
10. Carroll JL, McColley SA, Marcus CL, Curtis S, Loughlin GM. Inability of clinical history to distinguish primary snoring from obstructive sleep apnea syndrome in children. Chest 1995; 108: 610-618.
11. Gozal D, Wang M, Pope DW. Objective sleepiness measures in pediatric obstructive sleep apnea. Pediatrics 2001; 108: 693-697.
12. Hill W. On some causes of backwardness and stupidity in children: and the relief of the symptoms in some instances by nasopharyngeal scarifications. BMJ 1889; 11: 711-712.
13. Weissbluth M, Davis A, Poncher J, Reiff J. Signs of airway obstruction during sleep and behavioral, developmental and academic problems. Dev Behav Pediatr 1983; 4: 119-121.
14. Leach J, Olson J, Hermann J, Manning S. Polysomnographic and clinical findings in children with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 1992; 118: 741-744.
15. Singer LP, Saenger P. Complications of pediatric obstructive sleep apnea. Otolaryngol Clin North Am 1990; 23: 665-676.
16. Guilleminault, C., Korobkin, R. Winkle, R. A review of 50 children with obstructive sleep apnea syndrome. Lung 1981; 159: 275-287.
17. Ali NJ, Pitson DJ, Stradling JR. Snoring, sleep disturbance, and behavior in 4-5 year olds. Arch Dis Child 1993; 68: 360-366.
18. Ali NJ, Pitson D, Stradling JR. Natural history of snoring and related behaviour problems between the ages of 4 and 7 years. Arch Dis Child 1994; 71: 74-76.
19. Chervin R, Dillon J, Bassetti C, Ganoczy D, Pituch K. Symptoms of sleep disorders, inattention, and hyperactivity in children. Sleep 1997; 20: 1185-1192.
20. Owens J, Opipari L, Nobile C, Spirito A. Sleep and daytime behavior in children with obstructive sleep apnea and behavioral sleep disorders. Pediatrics 1998; 102: 1178-1184.
21. Ali NJ, Pitson D, Stradling JR. Sleep disordered breathing: effects of adenotonsillectomy on behaviour and psychological functioning. Eur J Pediatr 1996; 155: 56-62.
22. Gozal D. Sleep-disordered breathing and school performance in children. Pediatrics 1998; 102: 616-620.
23. Fletcher EC. Effect of episodic hypoxia on sympathetic activity and blood pressure. Respir Physiol 2000; 119: 189-197.
24. Fletcher EC, Bao G, Li R. Renin activity and blood pressure in response to chronic episodic hypoxia. Hypertension 1999; 34: 309-314.
25. Peled N, Greenberg A, Pillar G, Zinder O, Levi N, Lavie P. Contributions of hypoxia and respiratory disturbance index to sympathetic activation and blood pressure in obstructive sleep apnea syndrome. Am J Hypertens 1998; 11: 1284-1289.
26. Phillips BG, Somers VK. Neural and humoral mechanisms mediating cardiovascular responses to obstructive sleep apnea. Respir Physiol 2000; 119: 181-187.
27. Marcus CL, Greene MG, Carroll JL. Blood pressure in children with obstructive sleep apnea. Am J Respir Crit Care Med 1998; 157: 1098-1103.
28. Amin RS, Daniels S, Kimball T, Willging P, Cotton R. Echocardiographic changes in children with obstructive sleep apnea. Sleep 2000; 23: A99.
29. Aljadeff G, Gozal D, Shechtman VL, Burrell, B, Harper RM, Davidson Ward SL. Heart rate variability in children with obstructive sleep apnea. Sleep 1997; 20: 151-157.
30. Baharav A, Kotagal S, Rubin BK, Pratt J, Akselrod S. Autonomic cardiovascular control in children with obstructive sleep apnea. Clin Auton Res 1999; 9: 345-351.
31. Tal A, Leiberman A, Margulis G, Sofer S. Ventricular dysfunction in children with obstructive sleep apnea: radionuclide assessment. Pediatr Pulmonol 1988; 4: 139-143.
32. Sofer S, Weinhouse E, Tal A, Wanderman KL, Margulis G, Leiberman A, Gueron M. Cor pulmonale due to adenoidal or tonsillar hypertrophy or both in children. Noninvasive diagnosis and follow-up. Chest 1988; 93: 119-122.
33. Tang JR, Le Cras TD, Morris KG Jr, Abman SH. Brief perinatal hypoxia increases severity of pulmonary hypertension after reexposure to hypoxia in infant rats. Am J Physiol Lung Cell Mol Physiol 2000; 278: L356-L364.
34. Marcus CL, Carroll JL, Koerner CB, Hamer A, Lutz J, Loughlin GM. Determinants of growth in children with the obstructive sleep apnea syndrome. J Pediatr 1994; 125: 556-562.
35. Bar A, Tarasiuk A, Segev Y, Phillip M, Tal A. The effect of adenotonsillectomy on serum insulin-like growth factor-1 and growth in children with obstructive sleep apnea syndrome. J Pediatr 1999; 135: 76-80.
36. Soultan Z, Wadowski S, Rao M, Kravath RE. Effect of treating obstructive sleep apnea by tonsillectomy and/or adenoidectomy on obesity in children. Arch Pediatr Adolesc Med 1999; 153: 33-37.
37. Hudgel DW, Thanakitcharu S. Pharmacologic treatment of sleep-disordered breathing. Am J Respir Crit Care Med 1998; 158: 691-699.
38. Brouillette RT, Hanson D, David R, Klemka L, Szatowski A, Fernbach S, Hunt CA. Diagnostic approach to suspected obstructive sleep apnea in children. J Pediatr 1984; 105: 10-14.
39. Kahn A, Groswasser J, Sottiaux M, Rebuffat E, Sunseri M, Franco P, Dramaix M, Bochner A et al. Clinical symptoms associated with brief obstructive sleep apnea in normal infants. Sleep 1993; 16: 409-413.
40. Wang RC, Elkins TP, Keech D, Wauquier A, Hubbard D. Accuracy of clinical evaluation in pediatric obstructive sleep apnea. Otolaryngol Head Neck Surg 1998; 118: 69-73.
41. Brooks LJ, Stephens BM, Bacevice AM. Adenoid size is related to severity but not the number of episodes of obstructive apnea in children. J Pediatr 1998; 132: 682-686.
42. Goldstein NA, Sculerati N, Walsleben JA, Bhatia N, Friedman DM, Rapoport DM. Clinical diagnosis of pediatric obstructive sleep apnea validated by polysomnography. Otolaryngol Head Neck Surg 1994; 111: 611-617.
43. Brouillette RT, Morielli A, Leimanis A, Waters KA, Luciano R, Ducharme FM. Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep apnea. Pediatrics 2000; 105: 405-412.
44. Shintani T, Asakura K, Kataura A. The effect of adenotonsillectomy in children with OSA. Int J Pediatr Otorhinolaryngol 1998; 44: 51-58.
45. Suen JS, Arnold JE, Brooks LJ. Adenotonsillectomy for treatment of obstructive sleep apnea in children. Arch Otolaryngol Head Neck Surg 1995; 121: 525-530.
46. Nieminen P, Tolonen U, Lopponen H. Snoring and obstructive sleep apnea in children: a 6-month follow-up study. Arch Otolaryngol Head Neck Surg 2000; 126: 481-486.
47. Helfaer MA, McColley SA, Pyzik PL, Tunkel DE, Nichols DG, Baroody FM, April MM, Maxwell LG, Loughlin GM. Polysomnography after adenotonsillectomy in mild pediatric obstructive sleep apnea. Crit Care Med 1996; 24: 1323-1327.
48. Zucconi M, Ferini Strambi L, Pestalozza G, Tessitore E, Smirne S. Habitual snoring and obstructive sleep apnea syndrome in children: effects of early tonsil surgery. Int J Pediatr Otorhinolaryngol 1993; 26: 235-243.
49. Wiet GJ, Bower C, Seibert R, Griebel M. Surgical correction of obstructive sleep apnea in the complicated pediatric patient documented by polysomnography. Int J Pediatr Otorhinolaryngol 1997; 41: 133-143.
50. Agren K, Nordlander B, Linder-Aronson S, Zettergren-Wijk L, Svanborg E. Children with nocturnal upper airway obstruction: postoperative orthodontic and respiratory improvement. Acta Otolaryngol (Stockh) 1998; 118: 581-587.
51. Stradling JR, Thomas G, Warley ARH, Williams P, Freeland A. Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children. Lancet 1990; 335: 249-253.
52. Lind MG, Lundell BPW. Tonsillar hyperplasia in children. Arch Otolaryngol 1982; 108: 650-654.
53. Kudoh F, Sanai A. Effect of tonsillectomy and adenoidectomy on obese children with sleep-associated breathing disorders. Acta Otolaryngol (Stockh) 1996; Suppl. 523: 216-218.
54. Harvey JMM, O'Callaghan MJ, Wales PD, Harris MA, Masters IB. Six-month follow-up of children with obstrucitve sleep apnoea. J Paediatr Child Health 1999; 35: 136-139.
55. Brouillette RT, Fernbach SK, Hunt CE. Obstructive sleep apnea in infants and children. J Pediatr 1982; 100: 31-40.
56. Frank Y, Kravath RE, Pollak CP, Weitzman ED. Obstructive sleep apnea and its therapy: clinical and polysomnographic manifestations. Pediatrics 1983; 71: 737-742.
57. Potsic WP, Pasquariello PS, Corso Baranak C, Marsh RR, Miller LM. Relief of upper airway obstruction by adenotonsillectomy. Otolaryngol Head Neck Surg 1986; 94: 476-480.
58. Nishimura T, Morishima N, Hasegawa S, Shibata N, Iwanaga K, Yagisawa M. Effect of surgery on obstructive sleep apnea. Acta Otolaryngol (Stockh) 1996; 523: 231-233.
59. Alqvist-Rastad J, Hultcrantz E, Svanholm H. Children with tonsillar obstruction: indications for and efficacy of tonsillectomy. Acta Paediatr Scand 1988; 77: 831-835.
60. Hultcrantz E, Linder A, Markstrom A. Tonsillectomy or tonsillotomy? - A randomized study comparing postoperative pain and long-term effects. Int J Pediatr Otorhinolaryngol 1999; 51: 171-176.
61. ATS Consensus Statement - Cardiorespiratory sleep studies in children: establishment of normative data and polysomnographic predictors of morbidity. Am J Resp Crit Care Med 1999; 160: 1381-1387.
62. Rosen CL, Morton S, Larkin E, Aylor J, Clark K, O'Malla B, Graham G, Redline S. Persistence of sleep disordered breathing in children post-tonsillectomy. Am J Respir Crit Care Med 2001; 163: A184.
63. Rowe LD. Tonsils and adenoids: when is surgery indicated?: In: Common Problems of the Head and Neck. Philadelphia: WB Saunders 1995; 107-109.
64. McColley SA, April MM, Carroll JL, Nacleiro RM, Loughlin GM. Respiratory compromise after adenotonsillectomy in children with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 1992; 118: 940-943.
65. Rosen GM, Muckle RP, Mahowald MW, Goding GS, Ullevig C. Postoperative respiratory compromise in children with obstructive sleep apnea syndrome: can it be anticipated? Pediatrics 1994; 93: 784-788.
66. Price SD, Hawkins DB, Kahlstrom EJ. Ear Nose Throat J 1993; 72: 526-531.
67. Williams EF 3rd, Woo P, Miller R, Kellman RM. Otolaryngol Head Neck Surg 1991; 104: 509-516.
68. Ruboyianes JM, Cruz RM. Pediatric adenotonsillectomy for obstructive sleep apnea. ENT-Ear Nose Throat J 1996; 75: 430-433.
69. McGowan FX, Kenna MA, Fleming JA, O'Connor T. Adenotonsillectomy for upper airway obstruction carries increased risk in children with a history of prematurity. Pediatr Pulmonol 1992; 13: 222-226.
70. Friedman O, Chidekel A, Lawless ST, Cook SP. Postoperative bilevel positive airway pressure ventilation after tonsillectomy and adenoidectomy in children - a preliminary report. Int J Pediatr Otorhinolaryngol 1999; 51: 177-180.
71. Milerad J, Lagercrantz H, Johnso P. Obstuctive sleep apnea in Arnold-Chiari malformation treated with acetazolamide. Acta Paediatr 1992; 81: 609-612.
72. Al-Ghamdi SA, Manoukian JJ, Morielli A, Oudjhane K, Ducharme FM, Brouillette RT. Do systemic corticosteroids effectively treat obstructive sleep apnea secondary to adenotonsillar hypertrophy? Laryngoscope 1997; 107: 1382-1387.
73. Brouillette RT, Manoukian JJ, Ducharme FM, Oudiane K, Earle LG, Ladan S, Morielli A. Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea. J Pediatr 2001; 138: 838-844.
74. Demain JG, Goetz DW. Pediatric adenoidal hypertrophy and nasal airway obstruction: reduction with aqueous nasal beclomethasone. Pediatrics 1995; 95: 355-364.
75. Aljadeff G, Gozal D, Bailey-Wahl SL, Burrell B, Keens TG, Davidson Ward SL. Effect of overnight supplemental oxygen in obstructive sleep apnea in children. Am J Resp Crit Care Med 1996; 153: 51-55.
76. Marcus CL, Carroll JL, Bamford O, Pyzik P, Loughlin GM. Supplemental oxygen during sleep in children with sleep-disordered breathing. Am J Respir Crit Care Med 1995; 152: 1297-1301.
77. Rains JC. Treatment of obstructive sleep apnea in pediatric patients. Behavioral intervention for compliance with nasal continuous positive airway pressure. Clin Pediatr (Phila) 1995; 34: 535-541.
78. Li KK, Riley RW, Guilleminault C. An unreported risk in the use of home nasal continuous positive airway pressure and home nasal ventilation in children: midface hypoplasia. Chest 2000; 117: 916-918.
79. Downey R 3rd, Perkin RM, MacQuarrie J. Nasal continuous positive airway pressure use in children with obstructive sleep apnea younger than 2 years of age. Chest 2000; 117: 1608-1612.
80. Marcus CL, Ward SL, Mallory GB, Rosen CL, Beckerman RC, Weese-Mayer DE, Brouillette RT, Trang HT, Brooks LJ. Use of nasal continuous positive airway pressure as treatment of childhood obstructive sleep apnea. J Pediatr 1995; 127: 88-94.
81. Guilleminault C, Pelayo R, Clerk A, Leger D, Bocian RC. Home nasal continuous positive airway pressure in infants with sleep disordered breathing. J Pediatr 1995; 127: 905-912.
82. Waters KA, Everett FM, Bruderer JW, Sullivan CE. Obstructive sleep apnea: the use of nasal CPAP in 80 children. Am J Respir Crit Care Med 1995; 152: 780-785.
83. McNamara F, Sullivan CE. Obstructive sleep apnea in infants and its management with nasal continuous positive airway pressure. Chest 1999; 116: 10-16.
84. McNamara F, Sullivan CE. Effects of CPAP therapy on respiratory and spontaneous arousals in infants with OSA. J Appl Physiol 1999; 87: 889-896.
85. Cohen SR, Ross DA, Burstein FD, Lefaivre JF, Riski JE, Simms C. Skeletal expansion combined with soft-tissue reduction in the treatment of obstructive sleep apnea in children: physiologic results. Otolaryngol Head Neck Surg 1998; 119: 476-485.
86. Cohen SR, Simms C, Burstein FD, Thomsen J. Alternatives to tracheostomy in infants and children with obstructive sleep apnea. J Pediatr Surg 1999; 34: 182-186.
87. Januszkiewicz JS, Cohen SR, Burstein FD, Simms C. Age related outcomes of sleep apnea surgery in infants and children. Ann Plast Surg 1997; 38: 465-477.
88. Cohen SR, Lefaivre JF, Burstein FD, Simms C, Kattos AV, Scott PH, Montgomery GL, Graham L. Plast Reconstr Surg 1997; 99: 638-646.
89. Hoeve HLJ, Joosten KFM, van den Berg S. Management of obstructive sleep apnea syndrome in children with craniofacial malformation. Int J Pediatr Otorhinolaryngol 1999; 49 (Suppl. 1): S59-S61.
90. Bull MJ, Givan DC, Sadove AM, Bixler D, Hearn D. Improved outcome in Pierre-Robin sequence: effect of multidisciplinary evaluation and management. Pediatrics 1990; 86: 294-301.
91. Strome M. Obstructive sleep apnea in Down syndrome children: a surgical approach. Laryngoscope 1986; 96: 1340-1342.
92. Bower CM, Richmond D. Tonsillectomy and adenoidectomy in patients with Down syndrome. Int J Pediatr Otorhinolaryngol 1995; 33: 141-148.
93. Donaldson JD, Redmond WM. Surgical management of obstructive sleep apnea in children with Down syndrome. J Otolaryngol 1988; 17: 398-403.
94. Kosko JR, Derkay CS. Uvulopalatopharyngoplasty: treatment of obstructive sleep apnea in neurologically impaired pediatric patients. Int J Pediatr Otorhinolaryngol 1995; 32: 241-246.
95. Magardino TM, Tom LWC. Surgical management of obstructive sleep apnea in children with cerebral palsy. Laryngoscope 1999; 109: 1611-1615.
96. Seid AB, Martin PJ, Pransky SM, Kearns DB. Surgical therapy of obstructive sleep apnea in children with severe mental insufficiency. Laryngoscope 1990; 100: 507-510.
97. Kirk VG, Morielli A, Gozal D, Marcus CL, Waters KA, D'Andrea LA, Rosen CL, Deray MJ et al. Treatment of sleep-disordered breathing in children with myelomeningocele. Pediatr Pulmonol 2000; 30: 445-452.
98. James D, Ma L. Mandibular reconstruction in children with obstructive sleep apnea due to micrognathia. Plast Reconstr Surg 1997; 100: 1131-1137.
99. Bell RB, Turvey TA. Skeletal advancement for the treatment of obstructive sleep apnea in children. Cleft Palate Craniofac J 2001; 38: 147-154.
100. Uemara T, Hayashi T, Satoh K, Mitsukawa N, Yoshikawa A, Jinnnai T, Hosaka Y. A case of improved obstructive sleep apnea by distraction osteogenesis midface hypoplasia of an infantile Crouzon's syndrome. J Craniofacial Surg 2001; 12: 73-77.