Obstructive sleep apnoea in children – clinical presentation, diagnosis, treatment
DOI:
https://doi.org/10.12775/JEHS.2025.81.66650Keywords
obstructive sleep apnea, children, diagnosis, treatment, snoring, polysomnography, adenotonsillectomyAbstract
Introduction and purpose
The diagnosis of OSA in children is based on clinical symptoms and polysomnography (Apnea-Hypopnea Index ≥1 or hypoventilation). The ICSD-3 (International Classification of Sleep Disorders - Third Edition) guidelines are also utilized. Diagnostics are supported by pulse oximetry, lateral nasopharyngeal X-ray, cephalometry, fiberoptic endoscopy, and magnetic resonance imaging of the upper respiratory tract. OSA is associated with serious complications, including behavioral disorders, cardiovascular complications, metabolic disorders, and growth disturbances. Children with OSA also experience learning difficulties and lower school performance. Treatment includes adenotonsillectomy, CPAP/BiPAP therapy, surgical procedures, weight reduction, and pharmacotherapy. The effectiveness of treatment may be limited, particularly in obese children. Post-treatment monitoring of patients is necessary due to the risk of residual symptoms.
Material and methods
The literature available in Pubmed and Google Scholar databases was conducted using the key words.
Results
Data indicate that OSA occurs in approx. 5% of children, especially during the preschool years and adolescence. Symptoms include loud snoring, respiratory pauses, behavioral disorders, school difficulties, and daytime sleepiness. Polysomnography remains the cornerstone of diagnosis, supported by the PSQ and modified STOP-BANG questionnaires. Untreated OSA leads to metabolic, cardiovascular, and neurobehavioral complications. Treatment includes adenotonsillectomy, PAP therapy, weight reduction, pharmacotherapy, and orthodontic management.
Conclusions
Obstructive sleep apnea in children is a disorder with significant health consequences, requiring prompt diagnosis and tailored treatment. Adenotonsillectomy is the primary treatment method, with additional therapies applied to patients with persistent symptoms or contraindications to surgery.
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Copyright (c) 2025 Maria Ochwat, Oliwia Osiak, Anna Piecha, Jagoda Pawlak, Sara Orłowska, Łukasz Bednarczyk, Maja Pękala, Katarzyna Niedziółka, Michał Oborski
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