OBSTRUCTIVE SLEEP APNOEA IN CHILDREN

Obstructive breathing disorders in sleep are a common problem in children that can have serious cardiovascular, neurocognitive, and metabolic consequences. The most common disorder is obstructive sleep apnoea, which is characterised by partial or complete obstruction of the upper airway, with resultant hypoxia, hypercarbia, increased respiratory effort, pronounced intrathoracic pressure changes and sleep fragmentation. The pathogenesis is not yet clearly understood. The diagnostic method of choice is polysomnography. Mild forms of obstructive sleep apnoea can be treated medically (leukotriene receptor antagonists and nasal glucocorticoids). Adenotonsillectomy is a very efficacious surgical treatment method in children with obstructive sleep apnoea and adenotonsillar hypertrophy. Children with a high body mass index, high-grade obstruction or other associated conditions are more likely to have postoperative residual obstruction. These children are treated by the application of continuous positive airway pressure through a mask.