Sleep disordered breathing in children: what a pediatrician needs to know?

Obstructive sleep disordered breathing (SDB) is defined by the presence of recurrent partial or complete upper airway obstruction (hypopneas, obstructive or mixed apneas) with disruption of normal oxygenation, ventilation and sleep pattern. SDB is quite common in otherwise healthy children but the prevalence in children with congenital and genetic diseases is higher often with a more severe form of OSAS. Its consequences encompassed metabolic, cardiovascular and neurocognitive alterations. Clinical symptoms vary according to age, with some diurnal and nocturnal symptoms. No questionnaire had demonstrated a good reliability for the diagnosis of SDB and for the prediction of its severity. The mainstem of treatment is represented by adenotonsillectomy, with a good response in almost two tiers of patients. For those who failed to improve or who relapse other therapeutic options may be continuous positive pressure (CPAP) or noninvasive ventilation (NIV).