Pediatric sleep apnea-a simplified approach

Pediatric sleep-disordered breathing in children is a spectrum of primary snoring, upper airway resistance syndrome, obstructive hypoventilation, and obstructive sleep apnea syndrome (OSAS). The prevalence of pediatric OSAS is 1%-3%. Pediatric OSAS is most commonly caused by adenoid and tonsillar hypertrophy, which is correctable by surgery. The gold standard test for diagnosis is polysomnography (PSG). OSA in children is a distinct disorder form that occurs in adults with respect to clinical manifestations, PSG diagnostic criteria, and treatment approaches. In addition, PSG has its own challenges in children. Hence, simplification of approach by appropriate use of alternative diagnostic tests including oximetry scoring systems, questionnaires, and home respiratory polygraphy is highlighted. This will ensure early diagnosis, referral for corrective surgical management versus medical therapy on basis of severity, and performance of PSG in only selective cases.