Laura Whitla1, Paul Lennon2. 1. a Department of Paediatrics , University Hospital Waterford , Waterford , Ireland. 2. b Otolaryngology, Head and Neck Surgery , University Hospital Waterford , Ireland.
Abstract
BACKGROUND: Obstructive sleep apnoea is common in children and, if untreated, can lead to multiple medical sequelae. The Childhood Adenotonsillectomy Trial demonstrated benefit from early surgical intervention, but rapid access to such treatment is not always available. AIMS: To examine the recent literature on non-surgical aspects of the management of paediatric obstructive sleep apnoea (OSA). METHODS: The English language literature was searched for articles on the conservative management of OSA. RESULTS: In mild cases of OSA, intra-nasal steroids and other anti-inflammatory medications may give relief in mild cases of OSA, but the long-term safety of these treatments has not been established. Weight loss in obese children has been shown to be effective in selected patients but is limited in practice. Non-invasive ventilation may be effective but compliance can be a major obstacle. Oral appliances are effective by stenting the pharyngeal airway, but research in this area is limited. CONCLUSIONS: There are number of potential, if not proven, alternative management strategies for children with OSA, which could be considered in the absence of early surgical intervention.
BACKGROUND:Obstructive sleep apnoea is common in children and, if untreated, can lead to multiple medical sequelae. The Childhood Adenotonsillectomy Trial demonstrated benefit from early surgical intervention, but rapid access to such treatment is not always available. AIMS: To examine the recent literature on non-surgical aspects of the management of paediatric obstructive sleep apnoea (OSA). METHODS: The English language literature was searched for articles on the conservative management of OSA. RESULTS: In mild cases of OSA, intra-nasal steroids and other anti-inflammatory medications may give relief in mild cases of OSA, but the long-term safety of these treatments has not been established. Weight loss in obesechildren has been shown to be effective in selected patients but is limited in practice. Non-invasive ventilation may be effective but compliance can be a major obstacle. Oral appliances are effective by stenting the pharyngeal airway, but research in this area is limited. CONCLUSIONS: There are number of potential, if not proven, alternative management strategies for children with OSA, which could be considered in the absence of early surgical intervention.