Evidence-based practice: pediatric obstructive sleep apnea.

Diagnosis of sleep-disordered breathing (SDB) is most accurately obtained with a nocturnal polysomnogram. However, limitations on availability make alternative screening tools necessary. Nocturnal oximetry studies or nap polysomnography can be useful if positive; however, further testing is necessary to if these tests are negative. History and physical examination have insufficient sensitivity and specificity for diagnosingpediatric SDB. Adenotonsillectomy remains first-line therapy for pediatric SDB and obstructive sleep apnea (OSA). Additional study of limited therapies for mild OSA are necessary to determine if these are reasonable primary methods of treatment or if they should be reserved for children with persistent OSA.