State of the Art
When and why to treat the child who snores?
Hui-Leng Tan MD,
Maria Luz Alonso Alvarez MD,
Marina Tsaoussoglou PhD,
Silke Weber MD,
Athanasios G. Kaditis MD,
Corresponding Author
Hui-Leng Tan MD
Department of Pediatric Respiratory Medicine, Royal Brompton Hospital, Sydney St., London SW3 6NP, United Kingdom
Correspondence to: Hui-Leng Tan, MD, Department of Pediatric Respiratory Medicine, Royal Brompton Hospital, Sydney St., London SW3 6NP, UK. E-mail: [email protected]
Search for more papers by this authorMaria Luz Alonso Alvarez MD
Multidisciplinary Sleep Unit, Pulmonology, University Hospital of Burgos and CIBER of Respiratory Diseases (CIBERES), Burgos Foundation for Health Research, Burgos, Spain
Search for more papers by this authorMarina Tsaoussoglou PhD
Pediatric Pulmonology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece
Search for more papers by this authorSilke Weber MD
Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Botucatu Medical School, São Paulo State University-UNESP, Botucatu, São Paulo, Brazil
Search for more papers by this authorAthanasios G. Kaditis MD
Pediatric Pulmonology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece
Search for more papers by this authorHui-Leng Tan MD,
Maria Luz Alonso Alvarez MD,
Marina Tsaoussoglou PhD,
Silke Weber MD,
Athanasios G. Kaditis MD,
Corresponding Author
Hui-Leng Tan MD
Department of Pediatric Respiratory Medicine, Royal Brompton Hospital, Sydney St., London SW3 6NP, United Kingdom
Correspondence to: Hui-Leng Tan, MD, Department of Pediatric Respiratory Medicine, Royal Brompton Hospital, Sydney St., London SW3 6NP, UK. E-mail: [email protected]
Search for more papers by this authorMaria Luz Alonso Alvarez MD
Multidisciplinary Sleep Unit, Pulmonology, University Hospital of Burgos and CIBER of Respiratory Diseases (CIBERES), Burgos Foundation for Health Research, Burgos, Spain
Search for more papers by this authorMarina Tsaoussoglou PhD
Pediatric Pulmonology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece
Search for more papers by this authorSilke Weber MD
Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Botucatu Medical School, São Paulo State University-UNESP, Botucatu, São Paulo, Brazil
Search for more papers by this authorAthanasios G. Kaditis MD
Pediatric Pulmonology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece
Search for more papers by this authorConflicts of interest: None of the authors has any conflicts of interest to disclose.
Summary
Obstructive sleep-disordered breathing (SDB) can result in cardiovascular and neurocognitive morbidity as well as adversely affect behavior, growth, quality of life, and nocturnal continence. This article summarizes the latest evidence regarding the morbidity related to obstructive SDB, commenting on the impact of severity of obstruction, that is, the difference in effects seen of moderate to severe obstructive sleep apnea syndrome (OSAS) compared to those of mild OSAS or primary snoring. The impact of therapy is discussed, focusing on which children are likely to benefit from treatment interventions; namely those with moderate or severe OSAS irrespective of the presence of morbidity, children with mild OSAS with associated morbidity or predictors of SDB persistence such as obesity, and children with complex conditions accompanied by upper airway obstruction like craniosynostosis and Prader–Willi syndrome. The co-existing conditions which may improve when treatment for obstructive SDB is offered are reviewed, while the clinical parameters associated with spontaneous improvement or resolution of obstructive SDB are discussed. The intention being to enable clinicians to make informed decisions on who should be treated, when and why. Pediatr Pulmonol. 2017;52:399–412. © 2016 Wiley Periodicals, Inc.
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