In a revised clinical practice guideline, “Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome,” published in the September 2012 edition of Pediatrics, the American Academy of Pediatrics (AAP) recommends that all children or adolescents who snore regularly be screened for OSAS.
In addition, according to the article abstract, the following recommendations are made.
• Polysomnography should be performed in children/adolescents with snoring and symptoms/signs of OSAS; if polysomnography is not available, then alternative diagnostic tests or referral to a specialist for more extensive evaluation may be considered.
• Adenotonsillectomy is recommended as the first-line treatment of patients with adenotonsillar hypertrophy.
• High-risk patients should be monitored as inpatients postoperatively.
• Patients should be reevaluated postoperatively to determine whether further treatment is required. Objective testing should be performed in patients who are high risk or have persistent symptoms/signs of OSAS after therapy.
• Continuous positive airway pressure is recommended as treatment if adenotonsillectomy is not performed or if OSAS persists postoperatively.
• Weight loss is recommended in addition to other therapy in patients who are overweight or obese.
• Intranasal corticosteroids are an option for children with mild OSAS in whom adenotonsillectomy is contraindicated or for mild postoperative OSAS.