Materiały źródłowe

• #1 Pediatric obstructive sleep apnea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/symptoms-causes/syc-20376196

  Pediatric obstructive sleep apnea is a condition in which a child’s breathing is partly or completely blocked during sleep. […] It’s important for healthcare professionals to find and treat pediatric obstructive sleep apnea as soon as possible. Early treatment helps prevent other health conditions called complications. These can affect children’s growth, learning, behavior and heart health. The first treatment may be surgery to remove enlarged tonsils and adenoids. But some children may get better using medical devices or taking medicines. […] Without treatment, pediatric obstructive sleep apnea can lead to other health conditions called complications. Rarely, pediatric obstructive sleep apnea can cause infants and young children not to grow as much as those who don’t have the condition. Children who don’t receive treatment also may have a higher risk of later complications such as: […] In most children, treatment can help manage complications.

• #2 Pediatric Obstructive Sleep Apnea Diagnosis and Treatment: What You Need to Know – Pediatrics Nationwide

  https://pediatricsnationwide.org/2024/12/18/pediatric-obstructive-sleep-apnea-diagnosis-and-treatment-what-you-need-to-know/

  Pediatric obstructive sleep apnea, a common condition in children, is definitively diagnosed with sleep studies and can be treated through various modalities, depending on disease severity. […] Medical, dental and surgical approaches are available to treat OSA, but each case requires a personalized approach. […] Medical treatments include weight loss, anti-inflammatory medications and continuous positive airway pressure (CPAP). […] Adenotonsillectomy is the first-line surgical treatment option for pediatric OSA, but other surgical approaches, such as lingual tonsillectomy, may be used. […] Overall, tailoring the treatment to the individual characteristics of the patient through shared decision-making with families can help achieve the best treatment outcomes, he concluded.

• #3 Pediatric obstructive sleep apnea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/diagnosis-treatment/drc-20376199

  Some kids get better without sleep apnea treatments. It’s possible for some children with mild to moderate obstructive sleep apnea to outgrow the condition. A healthcare professional may recommend closely watching a child for up to six months to see if the symptoms get better. This is called watchful waiting. If the child also has allergies or other conditions that irritate the airway, watchful waiting can include treatment for those. […] Topical nasal steroids might ease sleep apnea symptoms for some children with mild obstructive sleep apnea. These medicines include fluticasone (Flovent HFA, Xhance, others) and budesonide (Rhinocort, Pulmicort Flexhaler, others). For kids with allergies, montelukast (Singulair) might help relieve symptoms when used alone or with nasal steroids. […] Adenotonsillectomy to remove the tonsils and adenoids might improve obstructive sleep apnea by opening the airway. It’s often a treatment option for children with moderate to severe obstructive sleep apnea. Your child’s primary healthcare professional might refer you to a pediatric ear, nose and throat specialist to talk about surgery. Other forms of upper airway surgery might be recommended based on your child’s condition.

• #4 Position Statement: Treatment of Obstructive Sleep Apnea – American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)

  https://www.entnet.org/resource/position-statement-treatment-of-obstructive-sleep-apnea/

  Treatment of Obstructive Sleep Apnea: Overview […] Obstructive Sleep Apnea (OSA) is a common disorder involving collapse of the upper airway during sleep. This repetitive collapse may result in sleep fragmentation, hypoxemia, hypercapnia, and increased sympathetic activity. OSA has been associated with an increased risk of many adverse health outcomes, including motor vehicle crashes, cognitive impairment, atrial fibrillation, stroke, and mortality. Daytime sleepiness and poor quality of life are other manifestations of OSA. As specialists in upper airway anatomy, physiology, and surgery, Otolaryngologists are uniquely qualified to treat patients with OSA. […] Pediatric OSA […] Surgical management, specifically adenotonsillectomy, is the recommended first line treatment for moderate to severe OSA in children. Children with mild OSA may be managed with watchful waiting, medical therapy with anti-inflammatory medications, or adenotonsillectomy. Children with persistent OSA following adenotonsillectomy may be managed with additional surgical therapy such as lingual tonsillectomy or continuous positive airway pressure (CPAP). Drug induced sleep endoscopy (DISE) is useful to determine the best management strategy in children with persistent OSA.

• #5 Pediatric Obstructive Sleep Apnea (OSA) | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/o/obstructive-sleep-apnea

  Pediatric obstructive sleep apnea (OSA) is a common, treatable condition. […] It’s important to treat pediatric obstructive sleep apnea as soon as possible. Treating it early can help the child maintain normal growth and development. […] A child’s treatment plan depends on what’s causing the pediatric obstructive sleep apnea. Treatments may include: […] Surgery: If enlarged tonsils and adenoids are causing the condition, your doctor will recommend removing them. This surgery is called an adenoidectomy or tonsillectomy. Your doctor may also recommend other surgeries if the condition is caused by different structural issues. […] Continuous positive airway pressure (CPAP): A CPAP machine provides air pressure that keeps the throat from closing during sleep. Your child will wear a small mask over their nose during sleep. A CPAP machine may be helpful when surgery is not possible.

• #6 Pediatric sleep disordered breathing: a narrative review – Narayanasamy – Pediatric Medicine

  https://pm.amegroups.org/article/view/5050/html

  Adenotonsillectomy has shown to improve the long-term outcomes in cardiovascular, cognitive, neuropsychological and quality of life measures in multiple studies. […] The most recent clinical practice guidelines in children having tonsillectomy for OSA and infectious causes was released in 2019 by American Academy of Otolaryngology-Head and Neck Surgery. […] The updated guidelines recommend against routine antibiotic use and administering codeine or codeine containing medications in children less than 12 years of age. […] The CHAT study which was the first randomized controlled trial to compare watchful waiting to tonsillectomy reported that the overall success rate for OSA in children having tonsillectomy was 79%. […] In children who underwent adenotonsillectomy, resolution of OSA was less likely in children with obesity and higher AHI at baseline.

• #7

  https://link.springer.com/article/10.1007/s40746-015-0022-8

  While adenotonsillectomy is the primary treatment for pediatric OSA, cure rates are variable with studies reporting persistent disease in 17 to 73 % of children. […] Drug-induced sleep endoscopy (DISE) can identify additional sites of obstruction in patients with persistent OSA after adenotonsillectomy and direct further surgical treatment. […] Adenotonsillectomy is the first-line treatment for children with moderate to severe OSA and adenotonsillar hypertrophy. […] Adenotonsillectomy improves quality of life and behavior in children with OSA. […] Patients at high risk for perioperative respiratory complications should be observed overnight in the hospital following adenotonsillectomy. […] Adenotonsillectomy is the mainstay of treatment in children with OSA and adenotonsillar enlargement.

• #8 Pediatric sleep disordered breathing: a narrative review – Narayanasamy – Pediatric Medicine

  https://pm.amegroups.org/article/view/5050/html

  Adenotonsillectomy has shown to improve the long-term outcomes in cardiovascular, cognitive, neuropsychological and quality of life measures in multiple studies. […] The most recent clinical practice guidelines in children having tonsillectomy for OSA and infectious causes was released in 2019 by American Academy of Otolaryngology-Head and Neck Surgery. […] The updated guidelines recommend against routine antibiotic use and administering codeine or codeine containing medications in children less than 12 years of age. […] The CHAT study which was the first randomized controlled trial to compare watchful waiting to tonsillectomy reported that the overall success rate for OSA in children having tonsillectomy was 79%. […] In children who underwent adenotonsillectomy, resolution of OSA was less likely in children with obesity and higher AHI at baseline.

• #9 Frontiers in the Management of Persistent Pediatric OSA | AAO-HNS Bulletin

  https://bulletin.entnet.org/aaohns-programs/article/22915079/frontiers-in-the-management-of-persistent-pediatric-osa

  The surgical management of persistent OSA has evolved in recent years as surgical approaches to sleep apnea in adults have been adapted for children. […] The most common second-stage procedures recommended for post-AT OSA in children are lingual tonsillectomy, supraglottoplasty, expansion pharyngoplasty, and turbinate reduction. […] Tracheostomy can be offered for children with severe persistent OSA when other treatments are not viable or fail to sufficiently improve disease burden. […] In 2023, the Food and Drug Administration (FDA) approved the HGNS implant for treatment of persistent OSA in children with Down syndrome who meet the following criteria: Age 13-18 years, prior adenotonsillectomy, CPAP intolerance or refusal, PSG that demonstrates persistent, severe OSA (AHI 10-50 with less than 25% of the total apnea index comprised of central or mixed apnea events).

• #10 Frontiers in the Management of Persistent Pediatric OSA | AAO-HNS Bulletin

  https://bulletin.entnet.org/aaohns-programs/article/22915079/frontiers-in-the-management-of-persistent-pediatric-osa

  The surgical management of persistent OSA has evolved in recent years as surgical approaches to sleep apnea in adults have been adapted for children. […] The most common second-stage procedures recommended for post-AT OSA in children are lingual tonsillectomy, supraglottoplasty, expansion pharyngoplasty, and turbinate reduction. […] Tracheostomy can be offered for children with severe persistent OSA when other treatments are not viable or fail to sufficiently improve disease burden. […] In 2023, the Food and Drug Administration (FDA) approved the HGNS implant for treatment of persistent OSA in children with Down syndrome who meet the following criteria: Age 13-18 years, prior adenotonsillectomy, CPAP intolerance or refusal, PSG that demonstrates persistent, severe OSA (AHI 10-50 with less than 25% of the total apnea index comprised of central or mixed apnea events).

• #11 Frontiers in the Management of Persistent Pediatric OSA | AAO-HNS Bulletin

  https://bulletin.entnet.org/aaohns-programs/article/22915079/frontiers-in-the-management-of-persistent-pediatric-osa

  The surgical management of persistent OSA has evolved in recent years as surgical approaches to sleep apnea in adults have been adapted for children. […] The most common second-stage procedures recommended for post-AT OSA in children are lingual tonsillectomy, supraglottoplasty, expansion pharyngoplasty, and turbinate reduction. […] Tracheostomy can be offered for children with severe persistent OSA when other treatments are not viable or fail to sufficiently improve disease burden. […] In 2023, the Food and Drug Administration (FDA) approved the HGNS implant for treatment of persistent OSA in children with Down syndrome who meet the following criteria: Age 13-18 years, prior adenotonsillectomy, CPAP intolerance or refusal, PSG that demonstrates persistent, severe OSA (AHI 10-50 with less than 25% of the total apnea index comprised of central or mixed apnea events).

• #12 Frontiers in the Management of Persistent Pediatric OSA | AAO-HNS Bulletin

  https://bulletin.entnet.org/aaohns-programs/article/22915079/frontiers-in-the-management-of-persistent-pediatric-osa

  The surgical management of persistent OSA has evolved in recent years as surgical approaches to sleep apnea in adults have been adapted for children. […] The most common second-stage procedures recommended for post-AT OSA in children are lingual tonsillectomy, supraglottoplasty, expansion pharyngoplasty, and turbinate reduction. […] Tracheostomy can be offered for children with severe persistent OSA when other treatments are not viable or fail to sufficiently improve disease burden. […] In 2023, the Food and Drug Administration (FDA) approved the HGNS implant for treatment of persistent OSA in children with Down syndrome who meet the following criteria: Age 13-18 years, prior adenotonsillectomy, CPAP intolerance or refusal, PSG that demonstrates persistent, severe OSA (AHI 10-50 with less than 25% of the total apnea index comprised of central or mixed apnea events).

• #13 Frontiers in the Management of Persistent Pediatric OSA | AAO-HNS Bulletin

  https://bulletin.entnet.org/aaohns-programs/article/22915079/frontiers-in-the-management-of-persistent-pediatric-osa

  The surgical management of persistent OSA has evolved in recent years as surgical approaches to sleep apnea in adults have been adapted for children. […] The most common second-stage procedures recommended for post-AT OSA in children are lingual tonsillectomy, supraglottoplasty, expansion pharyngoplasty, and turbinate reduction. […] Tracheostomy can be offered for children with severe persistent OSA when other treatments are not viable or fail to sufficiently improve disease burden. […] In 2023, the Food and Drug Administration (FDA) approved the HGNS implant for treatment of persistent OSA in children with Down syndrome who meet the following criteria: Age 13-18 years, prior adenotonsillectomy, CPAP intolerance or refusal, PSG that demonstrates persistent, severe OSA (AHI 10-50 with less than 25% of the total apnea index comprised of central or mixed apnea events).

• #14 Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7141493/

  As mentioned above, PAP therapy is frequently used to treat children who manifest moderate to severe OSA after TA or as a primary intervention among those children with no evidence of enlarged tonsils and adenoids. […] Drug-induced sleep endoscopy (DISE) permits assessment of the upper airway using a flexible fiberoptic endoscope introduced via the nose during spontaneous breathing while the patient is under conscious sedation. […] Recent renewed interest in the implementation of myofunctional re-education as an approach aimed to reduce the frequency or severity of residual OSA in children. […] RME usually consists of a fixed appliance with an expansion system that is affixed to opposing teeth and then progressively used to open the midpalatal suture, thus increasing the transverse diameter of the hard palate over the course of several weeks to months.

• #15

  https://link.springer.com/article/10.1007/s40746-015-0022-8

  While adenotonsillectomy is the primary treatment for pediatric OSA, cure rates are variable with studies reporting persistent disease in 17 to 73 % of children. […] Drug-induced sleep endoscopy (DISE) can identify additional sites of obstruction in patients with persistent OSA after adenotonsillectomy and direct further surgical treatment. […] Adenotonsillectomy is the first-line treatment for children with moderate to severe OSA and adenotonsillar hypertrophy. […] Adenotonsillectomy improves quality of life and behavior in children with OSA. […] Patients at high risk for perioperative respiratory complications should be observed overnight in the hospital following adenotonsillectomy. […] Adenotonsillectomy is the mainstay of treatment in children with OSA and adenotonsillar enlargement.

• #16 Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7141493/

  Treatment approaches to pediatric obstructive sleep apnea (OSA) have remarkably evolved over the last two decades. […] The treatment options for residual OSA after TA encompass a large spectrum of approaches, which may be complementary, and clearly require multidisciplinary cooperation. Among these, continuous positive airway pressure (CPAP), combined anti-inflammatory agents, rapid maxillary expansion, and myofunctional therapy are all part of the armamentarium, albeit with currently low-grade evidence supporting their efficacy. […] In addition to anti-inflammatory therapy, non-invasive positive airway pressure (PAP) therapy has clearly been the most frequently selected treatment option for children who present with moderate to severe OSA after TA. […] In obese children with residual OSA, efforts to promote weight loss need to be encouraged, both as a viable therapy for OSA but also for the health promoting effects that weight loss imposes on long-term and short-term morbidity in childhood obesity.

• #17 Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

  https://www.mdpi.com/2077-0383/9/3/888

  Treatment approaches to pediatric obstructive sleep apnea (OSA) have remarkably evolved over the last two decades. From an a priori assumption that surgical removal of enlarged upper airway lymphadenoid tissues (T&A) was curative in the vast majority of patients as the recommended first-line treatment for pediatric OSA, residual respiratory abnormalities are frequent. […] The treatment options for residual OSA after T&A encompass a large spectrum of approaches, which may be complementary, and clearly require multidisciplinary cooperation. Among these, continuous positive airway pressure (CPAP), combined anti-inflammatory agents, rapid maxillary expansion, and myofunctional therapy are all part of the armamentarium, albeit with currently low-grade evidence supporting their efficacy. […] In addition to anti-inflammatory therapy, non-invasive positive airway pressure (PAP) therapy has clearly been the most frequently selected treatment option for children who present with moderate to severe OSA after T&A.

• #18 Pediatric Obstructive Sleep Apnea – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/obstructive-sleep-apnea

  The treatment for obstructive sleep apnea is based on the cause. It may include: […] Surgery to remove the enlarged tonsils and adenoids. Your childs healthcare provider will discuss the risks and benefits with you. […] Weight loss. If your child is overweight, losing weight may ease symptoms. […] Continuous positive airway pressure (CPAP). While sleeping, your child wears a special mask that delivers a steady stream of air to keep his or her airway open. Some children may have trouble getting used to the mask. […] Rapid maxillary expansion. This is a device put in place by an orthodontist. The device widens the palate and nasal passages. […] Inhaled steroids. These medicines may help children with mild or moderate obstructive sleep apnea caused by enlarged tonsils. […] Staying away from secondhand smoke, indoor pollutants and allergens. This is important for children who also have nasal congestion. […] Treatment will depend on your childs symptoms, age and general health. It will also depend on how severe the condition is.

• #19 Pediatric obstructive sleep apnea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/diagnosis-treatment/drc-20376199

  In continuous positive airway pressure (CPAP), a small machine gently blows air through a tube attached to a mask affixed to the child’s nose or nose and mouth. This keeps the child’s airway open. […] Your child’s healthcare professional works with you to find the right treatment for your child’s pediatric obstructive sleep apnea. Most often, the first treatment for the condition is surgery to remove enlarged tonsils and adenoids. This is called adenotonsillectomy (ad-uh-no-ton-sil-EK-tuh-me). But some children get better with medicines or medical devices. […] The right treatment plan for your child depends on your child’s sleep apnea symptoms and risk factors. For most children, treatment includes adenotonsillectomy, but your child’s healthcare professional may recommend other treatments if this surgery isn’t right for your child. Other treatments also may be needed if the surgery doesn’t fully treat your child’s obstructive sleep apnea.

• #20 Pediatric Sleep Apnea Treatment – Atlantic Health

  https://ahs.atlantichealth.org/conditions-treatments/childrens-health/pediatric-sleep-disorders/treatment-obstructive-sleep-apnea-children.html

  There are several different methods for treating children with obstructive sleep apnea (OSA), but which one is most appropriate will often depend on the severity of the condition. […] The goal of care in most cases is to prevent obstructions from occurring by widening the airway. Our center accomplishes this though: […] Weight loss For overweight people with mild cases of OSA, diets and exercise may help alleviate symptoms. […] Surgical referral Surgical procedures, such as a tonsillectomy and adenoidectomy may be helpful for many children. […] Continuous Positive Airway Pressure CPAP, which is the most effective way to treat OSA, uses pressurized air to keep the airway open. This type of therapy requires the patient to sleep with a mask or tubing under the nose connected to an electrical machine that pressurizes the air in the room. […] Bilevel PAP While CPAP delivers air under constant pressure, Bilevel PAP provides air with varying pressure levels during inhalation and exhalation, improving comfort and tolerance. This is the preferred initial treatment for some patients.

• #21 Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

  https://www.mdpi.com/2077-0383/9/3/888

  As mentioned above, PAP therapy is frequently used to treat children who manifest moderate to severe OSA after T&A or as a primary intervention among those children with no evidence of enlarged tonsils and adenoids. […] Although there are clear benefits to PAP therapy, some problems and concerns deserve mention besides suboptimal adherence. Nasal bridge pressure sores from the masks, abdominal distension, oronasal dryness, eye irritation and overall discomfort from air leaks are frequent. […] Recent renewed interest in the implementation of myofunctional re-education as an approach aimed to reduce the frequency or severity of residual OSA in children. […] Based on the assumption that increasing intraoral and upper airway introitus space will lead to reduced airflow resistance and foster airway patency, approaches aiming to achieve rapid maxillary expansion (RME) have been developed over many decades. […] Overall, it would appear that RME may have a role in carefully selected patients, more specifically in those presenting obvious malocclusion (i.e., high, narrow palate associated with deep bite, retrusive bite or crossbite) and OSA.

• #22 Pediatric sleep apnea Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/pediatric-sleep-apnea

  Surgery to remove the tonsils and adenoids often cures the condition in children. […] If needed, surgery also may be used to: Remove extra tissue at the back of the throat, Correct problems with the structures in the face, Create an opening in the windpipe to bypass the blocked airway if there are physical problems. […] Sometimes, surgery is not recommended or does not help. In that case, your child may use a continuous positive airway pressure (CPAP) device. […] It can take some time to get used to sleeping using CPAP therapy. Good follow-up and support from a sleep center can help your child overcome any problems using CPAP. […] Other treatments may include: Inhaled nasal steroids, Dental device. This is inserted into the mouth during sleep to keep the jaw forward and the airway open, Weight loss, for overweight children. […] In most cases, treatment completely relieves symptoms and problems from sleep apnea.

• #23 Medical Treatment of Obstructive Sleep Apnea in Children

  https://www.mdpi.com/2077-0383/12/15/5022

  Additional assessment and medical treatment strategies are frequently required when AT is not indicated or if there is persistent OSA after surgery, as well as when complex medical issues are present. The aim of this review is to summarize the current evidence for medical treatment of children with OSA. […] Many studies have investigated the effectiveness of anti-inflammatory medications, such as nasal steroids (NSs) or leukotriene receptor antagonists (montelukast), in children with mild to severe OSA since the pathophysiology of the condition has a significant inflammatory component. […] The aim of NS use is to decrease the volume of adenoids via suppression of inflammation when adenotonsillectomy is contraindicated or in children with mild OSA. […] A recent double blind, randomized, controlled trial of NSs for the treatment of OSA in children included 134 children aged 5 to 12 years.

• #24 Pediatric obstructive sleep apnea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/diagnosis-treatment/drc-20376199

  Some kids get better without sleep apnea treatments. It’s possible for some children with mild to moderate obstructive sleep apnea to outgrow the condition. A healthcare professional may recommend closely watching a child for up to six months to see if the symptoms get better. This is called watchful waiting. If the child also has allergies or other conditions that irritate the airway, watchful waiting can include treatment for those. […] Topical nasal steroids might ease sleep apnea symptoms for some children with mild obstructive sleep apnea. These medicines include fluticasone (Flovent HFA, Xhance, others) and budesonide (Rhinocort, Pulmicort Flexhaler, others). For kids with allergies, montelukast (Singulair) might help relieve symptoms when used alone or with nasal steroids. […] Adenotonsillectomy to remove the tonsils and adenoids might improve obstructive sleep apnea by opening the airway. It’s often a treatment option for children with moderate to severe obstructive sleep apnea. Your child’s primary healthcare professional might refer you to a pediatric ear, nose and throat specialist to talk about surgery. Other forms of upper airway surgery might be recommended based on your child’s condition.

• #25 Pediatric obstructive sleep apnea // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/pediatric-obstructive-sleep-apnea

  Your child’s healthcare professional works with you to find the right treatment for your child’s pediatric obstructive sleep apnea. Most often, the first treatment for the condition is surgery to remove enlarged tonsils and adenoids. This is called adenotonsillectomy (ad-uh-no-ton-sil-EK-tuh-me). But some children get better with medicines or medical devices. […] The right treatment plan for your child depends on your child’s sleep apnea symptoms and risk factors. For most children, treatment includes adenotonsillectomy, but your child’s healthcare professional may recommend other treatments if this surgery isn’t right for your child. Other treatments also may be needed if the surgery doesn’t fully treat your child’s obstructive sleep apnea. […] Topical nasal steroids might ease sleep apnea symptoms for some children with mild obstructive sleep apnea. These medicines include fluticasone (Flovent HFA, Xhance, others) and budesonide (Rhinocort, Pulmicort Flexhaler, others). For kids with allergies, montelukast (Singulair) might help relieve symptoms when used alone or with nasal steroids.

• #26 Pediatric obstructive sleep apnea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/diagnosis-treatment/drc-20376199

  Some kids get better without sleep apnea treatments. It’s possible for some children with mild to moderate obstructive sleep apnea to outgrow the condition. A healthcare professional may recommend closely watching a child for up to six months to see if the symptoms get better. This is called watchful waiting. If the child also has allergies or other conditions that irritate the airway, watchful waiting can include treatment for those. […] Topical nasal steroids might ease sleep apnea symptoms for some children with mild obstructive sleep apnea. These medicines include fluticasone (Flovent HFA, Xhance, others) and budesonide (Rhinocort, Pulmicort Flexhaler, others). For kids with allergies, montelukast (Singulair) might help relieve symptoms when used alone or with nasal steroids. […] Adenotonsillectomy to remove the tonsils and adenoids might improve obstructive sleep apnea by opening the airway. It’s often a treatment option for children with moderate to severe obstructive sleep apnea. Your child’s primary healthcare professional might refer you to a pediatric ear, nose and throat specialist to talk about surgery. Other forms of upper airway surgery might be recommended based on your child’s condition.

• #27 How to Treat Sleep Apnea in Children | Cedars-Sinai

  https://www.cedars-sinai.org/blog/pediatric-obstructive-sleep-apnea.html

  Mild sleep apnea (which can be caused by allergies or enlarged tonsils or adenoids) can be treated with an oral medication, such as montelukast or different types of nasal steroid or antihistamine sprays. […] For children who have moderate to severe sleep apnea, the gold standard of treatment is to remove part or all of the tonsils and the adenoids. […] Continuous positive airway pressure (CPAP) machines can also be a treatment option for patients who have already gotten a tonsillectomy and adenoidectomy but still have significant sleep apnea. […] Some children who have mild sleep apnea may be medically managed and may not necessarily need surgical therapy. Children who tend to have moderate and severe sleep apnea, however, often dont get better until they have surgical treatment (removing part or all of the tonsils and adenoids).

• #28 Medical Treatment of Obstructive Sleep Apnea in Children

  https://www.mdpi.com/2077-0383/12/15/5022

  Gozal et al. included 64 children in a randomized, controlled study evaluating the effect of montelukast therapy. […] According to a meta-analysis, five studies with 166 children that evaluated montelukast alone for pediatric OSA revealed a 55% improvement in the AHI. […] Since enlarged adenoids and tonsils are composed of hypertrophic lymphoid tissue, anti-inflammatory medications, such as systemic corticosteroids, have been evaluated for treatment of children with OSA. […] Various microorganisms have been isolated from patients with chronic tonsillar hypertrophy. […] It is important to consider that residual OSA may remain even after surgical intervention, especially in children with complex disorders, such as Trisomy 21, Prader–Willi syndrome, or obesity. […] Children who are not candidates for surgery, most children with cranio-facial anomalies, and children with persistent OSA after adenotonsillectomy are usually started on positive airway pressure (PAP) therapy.

• #29 Frontiers in the Management of Persistent Pediatric OSA | AAO-HNS Bulletin

  https://bulletin.entnet.org/aaohns-programs/article/22915079/frontiers-in-the-management-of-persistent-pediatric-osa

  Persistent pediatric obstructive sleep apnea (OSA) after adenotonsillectomy (AT) is a common challenge faced by many otolaryngologists. […] Given the harmful effects of untreated OSA which can include behavioral and mental health challenges and development or exacerbation of cardiovascular disease, many families report significant quality-of-life impacts and psychological burden associated with their child’s OSA. […] Children with persistent OSA are often recommended a trial of continuous positive airway pressure (CPAP) therapy. […] Medical management with a leukotriene inhibitor like montelukast with or without nasal steroids is effective for mild persistent OSA, but montelukast must be prescribed with caution in children with baseline behavioral or mood disorders due to concerns regarding mental health changes.

• #30 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  Systemic glucocorticoids are not effective in the treatment of pediatric OSA. However, intranasal steroid treatment for six weeks has been shown to improve the AHI and can also be considered a treatment option for patients with mild to moderate OSA. When intranasal steroids are used in combination with leukotriene inhibitors, the majority of patients will have a clinically significant decrease in AHI. […] If there is adenotonsillar hypertrophy, the most effective treatment is adenotonsillectomy (AT). This is recommended for most patients with an AHI more than 9 events/hour and those with mild or moderate disease with significant symptoms. A partial tonsillectomy is also an option that decreases both postoperative complications and recovery time, but it has been shown that tonsillar regrowth rates are between 7.2% to 16.6%. Other surgical methods, including lingual tonsillectomy and uvulopalatopharyngoplasty, have limited data and have been shown to be non-superior. One of the more conservative treatments, adenotonsillotomy, has not been shown to be superior to AT in the treatment of pediatric OSA. There is an increased risk of recurrence of OSA, and the possible need for repeat surgery with adenotonsillectomy should be taken into consideration.

• #31 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  For patients with mild to moderate OSA, „watchful waiting” for up to six months can be appropriate. This is usually done to attempt to correct underlying problems, like obesity or allergic rhinitis, that could improve OSA and AHI without surgical intervention. However, in pediatric patients who are non-obese and non-syndromic, AT is superior in the improvement of the AHI. […] Continuous positive airway pressure (CPAP) is another potential treatment option. While this is the first-line treatment in adults, there are limitations to the use of PAP in children. PAP should be considered during the perioperative phase before AT for severe OSA if the child is not a good surgical candidate or has persistent moderate to severe OSA despite surgery. Compliance can be difficult for children, and the use of the same mask over time has the potential to change the facial structure.

• #32 Pediatric obstructive sleep apnea – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/diagnosis-treatment/drc-20376199

  In continuous positive airway pressure (CPAP), a small machine gently blows air through a tube attached to a mask affixed to the child’s nose or nose and mouth. This keeps the child’s airway open. […] Your child’s healthcare professional works with you to find the right treatment for your child’s pediatric obstructive sleep apnea. Most often, the first treatment for the condition is surgery to remove enlarged tonsils and adenoids. This is called adenotonsillectomy (ad-uh-no-ton-sil-EK-tuh-me). But some children get better with medicines or medical devices. […] The right treatment plan for your child depends on your child’s sleep apnea symptoms and risk factors. For most children, treatment includes adenotonsillectomy, but your child’s healthcare professional may recommend other treatments if this surgery isn’t right for your child. Other treatments also may be needed if the surgery doesn’t fully treat your child’s obstructive sleep apnea.

• #33 Pediatric obstructive sleep apnea | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/pediatric-obstructive-sleep-apnea?content_id=CON-20376186

  Topical nasal steroids might ease sleep apnea symptoms for some children with mild obstructive sleep apnea. […] Your child’s healthcare professional may recommend use of devices such as: Positive airway pressure therapy. […] Adenotonsillectomy to remove the tonsils and adenoids might improve obstructive sleep apnea by opening the airway. It’s often a treatment option for children with moderate to severe obstructive sleep apnea. […] If your child is obese, ask your child’s healthcare professional about a weight-loss plan. […] Some children may outgrow their obstructive sleep apnea while their healthcare professionals track their health. This is especially true for kids with mild disease and no other risk factors.

• #34 Pediatric Sleep Disordered Breathing / Obstructive Sleep Apnea |

  https://www.bmc.org/patient-care/conditions-we-treat/db/pediatric-sleep-disordered-breathing-obstructive-sleep-apnea

  Enlarged tonsils and adenoids are a common cause for SDB. Surgical removal of the tonsils and adenoids (TA) is generally considered the first line treatment for pediatric sleep disordered breathing if the symptoms are significant and the tonsils and adenoids are enlarged. Of the over 500,000 pediatric TA procedures performed in the U.S. each year, the majority are currently being done to treat sleep disordered breathing. Many children with sleep apnea show both short and long-term improvement in their sleep and behavior after TA. […] Not every child with snoring should undergo TA as the procedure does have risks. Potential problems can include anesthesia or airway complications, bleeding, infection and problems with speech and swallowing. If the SDB symptoms are mild or intermittent, academic performance and behavior is not an issue, the tonsils are small, or the child is near puberty (tonsils and adenoids often shrink at puberty), it may be recommended that a child with SDB be watched conservatively and treated surgically only if symptoms worsen. Recent studies have shown that some children have persistent sleep disordered breathing after TA. A post-operative PSG may be necessary after surgical intervention, especially in children with persistent symptoms or increased risk factors for persistent apnea after TA such as obesity, craniofacial anomalies or neuromuscular problems. Additional treatments such as weight loss, the use of Continuous Positive Airway Pressure (CPAP) or additional surgical procedures may sometimes be required.

• #35 Treatment of pediatric obstructive sleep apnea

  https://www.kosinmedj.org/journal/view.php?doi=10.7180/kmj.24.120

  While there is a substantial amount of evidence indicating that surgical or nonsurgical weight loss improves OSA in adults, literature regarding the effects of weight loss on pediatric OSA improvement is somewhat limited. […] In the treatment of OSA, pharmacotherapy aims to reduce the size of the tonsils and adenoids. […] Orthodontic interventions targeting malocclusion and maxillofacial anomalies are also associated with the treatment of OSA. […] Adenotonsillar hypertrophy and obesity represent the predominant predisposing factors for OSA syndrome in pediatric populations, often accompanied by significant morbidity. Common treatment modalities include adenoidectomy alone or in combination with tonsillectomy, intranasal corticosteroids, oral appliances, and nasal CPAP.

• #36 Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7141493/

  As mentioned above, PAP therapy is frequently used to treat children who manifest moderate to severe OSA after TA or as a primary intervention among those children with no evidence of enlarged tonsils and adenoids. […] Drug-induced sleep endoscopy (DISE) permits assessment of the upper airway using a flexible fiberoptic endoscope introduced via the nose during spontaneous breathing while the patient is under conscious sedation. […] Recent renewed interest in the implementation of myofunctional re-education as an approach aimed to reduce the frequency or severity of residual OSA in children. […] RME usually consists of a fixed appliance with an expansion system that is affixed to opposing teeth and then progressively used to open the midpalatal suture, thus increasing the transverse diameter of the hard palate over the course of several weeks to months.

• #37 Treatment for Pediatric Obstructive Sleep Apnea – Airway & Sleep Group

  https://airwayandsleepgroup.com/blog/treatment-for-pediatric-obstructive-sleep-apnea/

  Obstructive sleep apnea in children is characterized by disordered breathing during sleep which consists of prolonged partial upper airway obstruction or complete obstruction, disrupting normal breathing patterns. […] Research has shown that early treatment is imperative in order to combat the destructive effects of pediatric OSA. Treatments for Pediatric OSA can either be dental or surgical or a combination. […] Treatment options for pediatric OSA that have been studied for the past two decades include; Rapid maxillary expansion, oral appliances and distraction osteogenesis. […] Rapid Maxillary Expansion (RME) is for children with narrow, high maxillary arches. RME expands the arch by connecting a device to the maxillary teeth and surrounding tissue and applying orthopaedic force. RME significantly reduces the problems associated with OSA and has long lasting results.

• #38 Treatment for Pediatric Obstructive Sleep Apnea – Airway & Sleep Group

  https://airwayandsleepgroup.com/blog/treatment-for-pediatric-obstructive-sleep-apnea/

  The next option is mandibular advancement with oral appliances. In children, mandibular advancement is a type of orthodontic therapy that helps improve and expand upper airway space and may be permanent if used early enough. […] Distraction osteogenesis is a surgical treatment option that treats abnormalities in the oral and facial skeleton. This is a more invasive treatment option for children with more serious developmental and growth concerns. Distraction osteogenesis has been proven to improve upper airway obstruction and other functional problems.

• #39 Treatment for Pediatric Obstructive Sleep Apnea – Airway & Sleep Group

  https://airwayandsleepgroup.com/blog/treatment-for-pediatric-obstructive-sleep-apnea/

  The next option is mandibular advancement with oral appliances. In children, mandibular advancement is a type of orthodontic therapy that helps improve and expand upper airway space and may be permanent if used early enough. […] Distraction osteogenesis is a surgical treatment option that treats abnormalities in the oral and facial skeleton. This is a more invasive treatment option for children with more serious developmental and growth concerns. Distraction osteogenesis has been proven to improve upper airway obstruction and other functional problems.

• #40 Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

  https://www.mdpi.com/2077-0383/9/3/888

  As mentioned above, PAP therapy is frequently used to treat children who manifest moderate to severe OSA after T&A or as a primary intervention among those children with no evidence of enlarged tonsils and adenoids. […] Although there are clear benefits to PAP therapy, some problems and concerns deserve mention besides suboptimal adherence. Nasal bridge pressure sores from the masks, abdominal distension, oronasal dryness, eye irritation and overall discomfort from air leaks are frequent. […] Recent renewed interest in the implementation of myofunctional re-education as an approach aimed to reduce the frequency or severity of residual OSA in children. […] Based on the assumption that increasing intraoral and upper airway introitus space will lead to reduced airflow resistance and foster airway patency, approaches aiming to achieve rapid maxillary expansion (RME) have been developed over many decades. […] Overall, it would appear that RME may have a role in carefully selected patients, more specifically in those presenting obvious malocclusion (i.e., high, narrow palate associated with deep bite, retrusive bite or crossbite) and OSA.

• #41 Treatment for Pediatric Obstructive Sleep Apnea – Airway & Sleep Group

  https://airwayandsleepgroup.com/blog/treatment-for-pediatric-obstructive-sleep-apnea/

  Obstructive sleep apnea in children is characterized by disordered breathing during sleep which consists of prolonged partial upper airway obstruction or complete obstruction, disrupting normal breathing patterns. […] Research has shown that early treatment is imperative in order to combat the destructive effects of pediatric OSA. Treatments for Pediatric OSA can either be dental or surgical or a combination. […] Treatment options for pediatric OSA that have been studied for the past two decades include; Rapid maxillary expansion, oral appliances and distraction osteogenesis. […] Rapid Maxillary Expansion (RME) is for children with narrow, high maxillary arches. RME expands the arch by connecting a device to the maxillary teeth and surrounding tissue and applying orthopaedic force. RME significantly reduces the problems associated with OSA and has long lasting results.

• #42 Medical Treatment of Obstructive Sleep Apnea in Children

  https://www.mdpi.com/2077-0383/12/15/5022

  PAP therapy can be administered as continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BPAP). […] High-flow nasal cannula (HFNC) treatment has been used to treat neonates with respiratory distress linked to prematurity in neonatal intensive care units with varying but generally positive effects. […] Children with OSA who cannot tolerate the CPAP masks may benefit from HFNC treatment. […] In positional OSA (POSA), the OSA occurs mostly while sleeping in the supine position, and this is known to affect 19–58% of children with OSA. […] A belt worn around the chest with pillows on the back to stop children from adopting the supine posture may be an effective treatment option for POSA. […] Myofunctional therapy (MT) is based on isotonic and isometric exercises that enhance the orofacial tissues’ coordination and strength.

• #43 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  Although oral appliances (OAs) have been shown to decrease AHI in adults, there have not been enough studies on pediatric populations to know their efficacies or which patients might benefit from these. Changing OAs to accommodate a child’s growth would also require frequent refittings. Rapid maxillary expansion, however, is a potential option for prepubescent patients and may be especially useful for those with high arched palates and non-obese patients with residual OSA after AT. […] Myofunctional therapy is a new area of study in the treatment of both pediatric and adult OSA. This consists of retraining the muscles of the oral cavity and oropharyngeal structures, as well as proper tongue positioning. There is limited data about efficacy in children, with only small studies on pediatric patients with OSA. However, this could be an area of future research and could serve as an adjunct in treating OSA.

• #44 How to Treat Obstructive Sleep Apnea in Kids and Teens

  https://www.verywellhealth.com/sleep-apnea-treatment-for-teens-adolescents-4082952

  Exercises of the tongue and lips may increase the muscle tone of the airway, promote nasal breathing, and reduce the risk of snoring and sleep apnea. […] CPAP therapy may be used in children or teenagers who have persistent sleep apnea despite other treatment efforts. […] This treatment is 85 percent effective. […] Older adolescents who have finished growing and have completed any required orthodontic work may be interested in using an oral appliance to treat sleep apnea. […] In children who are overweight or obese, a weight loss plan with improved nutrition and increased exercise may be indicated. […] Obstructive sleep apnea can be treated effectively and the role of a motivated parent in maximizing the impact of these interventions cannot be overstated.

• #45 Pediatric Sleep Apnea Treatment- correct the root cause

  https://tmjsleepandbreathecenter.com/how-to-cure-pediatric-sleep-apnea/

  Our practice performs laser frenectomy procedures to precisely release TOTs. This minimally invasive procedure releases the ties, significantly improving the child’s ability to breathe, eat, and speak more comfortably. […] Myofunctional therapy focuses on strengthening the tongue and other mouth muscles. This therapy teaches children how to properly use these muscles, promoting healthier breathing patterns and correcting mouth breathing, which is often linked to sleep apnea. […] Our practices commitment to addressing pediatric sleep apnea extends to the comprehensive treatment of related conditions like mouth breathing and night terrors. […] Pediatric obstructive sleep apnea (OSA) is a serious condition characterized by repeated upper airway obstruction during sleep, leading to health complications like high blood pressure and behavioral issues if left untreated.

• #46 Medical Treatment of Obstructive Sleep Apnea in Children

  https://www.mdpi.com/2077-0383/12/15/5022

  Gozal et al. included 64 children in a randomized, controlled study evaluating the effect of montelukast therapy. […] According to a meta-analysis, five studies with 166 children that evaluated montelukast alone for pediatric OSA revealed a 55% improvement in the AHI. […] Since enlarged adenoids and tonsils are composed of hypertrophic lymphoid tissue, anti-inflammatory medications, such as systemic corticosteroids, have been evaluated for treatment of children with OSA. […] Various microorganisms have been isolated from patients with chronic tonsillar hypertrophy. […] It is important to consider that residual OSA may remain even after surgical intervention, especially in children with complex disorders, such as Trisomy 21, Prader–Willi syndrome, or obesity. […] Children who are not candidates for surgery, most children with cranio-facial anomalies, and children with persistent OSA after adenotonsillectomy are usually started on positive airway pressure (PAP) therapy.

• #47 Obstructive Sleep Apnea in Pediatric Patients | RT

  https://respiratory-therapy.com/disorders-diseases/sleep-medicine/obstructive-sleep-apnea-in-pediatric-patients/

  Early recognition, accurate diagnosis, and appropriate treatment help to alleviate much of the childhood morbidity associated with obstructive sleep apnea. […] Diagnosis of OSA requires a careful and detailed history and physical examination. Polysomnography is required to determine the nature of the problem, the magnitude of the physiologic disturbance, and (ultimately) the significance of the problem for the child. […] Earlier recognition, accurate diagnosis, and appropriate treatment all should alleviate much of the childhood morbidity associated with these conditions. […] The most common treatment for young children with symptomatic OSA who have evidence of adenotonsillar hypertrophy is removal of the tonsils or adenoids, or both. […] Although adenotonsillectomy is helpful in relieving OSA in patients with adenotonsillar hypertrophy, children with severe disease or other contributing factors for OSA (Down syndrome, obesity, cerebral palsy, or craniofacial abnormalities) may not be completely cured by surgery.

• #48 Frontiers in the Management of Persistent Pediatric OSA | AAO-HNS Bulletin

  https://bulletin.entnet.org/aaohns-programs/article/22915079/frontiers-in-the-management-of-persistent-pediatric-osa

  The surgical management of persistent OSA has evolved in recent years as surgical approaches to sleep apnea in adults have been adapted for children. […] The most common second-stage procedures recommended for post-AT OSA in children are lingual tonsillectomy, supraglottoplasty, expansion pharyngoplasty, and turbinate reduction. […] Tracheostomy can be offered for children with severe persistent OSA when other treatments are not viable or fail to sufficiently improve disease burden. […] In 2023, the Food and Drug Administration (FDA) approved the HGNS implant for treatment of persistent OSA in children with Down syndrome who meet the following criteria: Age 13-18 years, prior adenotonsillectomy, CPAP intolerance or refusal, PSG that demonstrates persistent, severe OSA (AHI 10-50 with less than 25% of the total apnea index comprised of central or mixed apnea events).

• #49 Pediatric Down Syndrome & Obstructive Sleep Apnea | Inspire Sleep Apnea Innovation

  https://www.inspiresleep.com/en-us/pediatric-down-syndrome/

  While some children with Down syndrome do well with treatments like continuous positive airway pressure (CPAP) therapy to help treat their OSA, others are unable to tolerate it due to sensitivity challenges, which make wearing a CPAP mask extremely difficult as a long-term solution. […] Inspire therapy is the first FDA approved obstructive sleep apnea treatment that works inside the body to treat the root cause of sleep apnea. Through a small device implanted during a minimally invasive procedure, Inspire uses gentle stimulation to keep the airway open during sleep. […] Inspire therapy is a safe and effective alternative to treat OSA for those who are not effectively treated by current therapies like CPAP.

• #50 Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7141493/

  Treatment approaches to pediatric obstructive sleep apnea (OSA) have remarkably evolved over the last two decades. […] The treatment options for residual OSA after TA encompass a large spectrum of approaches, which may be complementary, and clearly require multidisciplinary cooperation. Among these, continuous positive airway pressure (CPAP), combined anti-inflammatory agents, rapid maxillary expansion, and myofunctional therapy are all part of the armamentarium, albeit with currently low-grade evidence supporting their efficacy. […] In addition to anti-inflammatory therapy, non-invasive positive airway pressure (PAP) therapy has clearly been the most frequently selected treatment option for children who present with moderate to severe OSA after TA. […] In obese children with residual OSA, efforts to promote weight loss need to be encouraged, both as a viable therapy for OSA but also for the health promoting effects that weight loss imposes on long-term and short-term morbidity in childhood obesity.

• #51 Pediatric Obstructive Sleep Apnea (OSA) | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/o/obstructive-sleep-apnea

  Weight loss: If weight is the cause of pediatric OSA, your doctor may recommend a weight loss plan. The plan may include diet changes and exercise. […] Medications: Your doctor may recommend a nasal steroid or allergy medicine. […] Your child may need to undergo a second PSG a few months after treating the pediatric obstructive sleep apnea. This second test can determine if the treatment or surgery worked. In some cases, the treatment can stop snoring but not cure pediatric OSA.

• #52 Best Practices in Pediatric Obstructive Sleep Apnea Treatment

  https://www.backtable.com/shows/ent/articles/pediatric-obstructive-sleep-apnea-treatment-best-practices

  Managing pediatric obstructive sleep apnea is particularly challenging in children who continue to have symptoms post-tonsillectomy and adenoidectomy (TNA). Continuous Positive Airway Pressure (CPAP) therapy can be an option, but often has a limited role in mild OSA cases due to compliance issues and potential effects on facial growth. In overweight children, weight management is crucial, as even a 10% reduction can significantly improve symptoms. Surgical management can only go so far if a child is significantly overweight, highlighting the importance of addressing weight issues with families and adopting a collaborative approach to treatment. […] In those, in the normal-weight child, I would heavily encourage avoiding CPAP, letting the child grow using sprays, allergy evaluation. If the adenoids have regrown, consider removing them. Can the child benefit from shrinking the turbinates?

• #53 Medical Treatment of Obstructive Sleep Apnea in Children

  https://www.mdpi.com/2077-0383/12/15/5022

  Although it has been suggested that a subset of craniofacial characteristics, including increased facial height, retrognathia, and a higher mandibular angle, may be more frequently present in children with OSA, a recent meta-analysis of nine studies revealed that, although a certain subgroup of pediatric OSA patients showed higher rates of specific craniofacial characteristics, this was not consistent across studies. […] Obesity is a risk factor for developing OSA. […] Bariatric surgery has been found to be beneficial in decreasing excess weight and alleviating comorbidities in adolescents with severe obesity. […] Considering the significant effects of obesity on OSA and the poor response to adenotonsillectomy in children with obesity, weight loss should be part of the treatment plan for all children with obesity and OSA. […] Although adenotonsillectomy remains the primary treatment for children with OSA, there are medical treatment options that can be considered.

• #54 How to Treat Obstructive Sleep Apnea in Kids and Teens

  https://www.verywellhealth.com/sleep-apnea-treatment-for-teens-adolescents-4082952

  Surgery, allergy treatment, and orthodontics work […] Learn how to treat obstructive sleep apnea in children and teenagers, including the roles of surgery, allergy treatment, orthodontics, CPAP therapy, weight loss, and alternative options like myofunctional therapy. […] Fortunately, there are effective treatment options available for this condition in children and adolescents, including: […] This is the most common surgical treatment for children with obstructive sleep apnea. […] This surgery works extremely well and the success rate is 80 percent. […] Allergies may be treated with nasal saline rinses, oral medications like montelukast (sold as the prescription Singulair), or steroid nasal sprays. […] This treatment works best in younger children and does not work after the growth spurt ends.

• #55 Sleep Apnea in Children- Symptoms, Diagnosis, and Natural Treatment

  https://www.resmed.co.in/blogs/how-to-diagnose-treat-sleep-apnea-in-children

  Pediatric Obstructive Sleep Apnea refers to a condition where kids fail to rest peacefully at night because of pauses in breathing. […] A few options for child sleep apnea treatment are as follows: […] The Continuous Positive Airway Pressure (CPAP) machine pumps air into the lungs to open up obstructions. […] Another way to improve obstructive sleep apnea in children is to practise mouth and throat exercises, also known as myofunctional therapy. […] To help with the flow of air through the airway, some orthodontic approaches recommend using dental hardware to create more space in the mouth. […] Using nasal sprays and saline nasal rinses can help children with mild sleep apnea. […] Since obesity is a risk factor for OSA, losing weight can alleviate its symptoms. […] Avoiding the causes of allergic rhinitis like pollen and mould can help reduce sleep apnea symptoms.

• #56 How to Treat Obstructive Sleep Apnea in Kids and Teens

  https://www.verywellhealth.com/sleep-apnea-treatment-for-teens-adolescents-4082952

  Surgery, allergy treatment, and orthodontics work […] Learn how to treat obstructive sleep apnea in children and teenagers, including the roles of surgery, allergy treatment, orthodontics, CPAP therapy, weight loss, and alternative options like myofunctional therapy. […] Fortunately, there are effective treatment options available for this condition in children and adolescents, including: […] This is the most common surgical treatment for children with obstructive sleep apnea. […] This surgery works extremely well and the success rate is 80 percent. […] Allergies may be treated with nasal saline rinses, oral medications like montelukast (sold as the prescription Singulair), or steroid nasal sprays. […] This treatment works best in younger children and does not work after the growth spurt ends.

• #57 Obstructive Sleep Apnea in Kids | UVA Health Children’s

  https://childrens.uvahealth.com/services/pediatric-sleep/sleep-apnea

  At UVA Health Childrens, our sleep specialists can diagnose obstructive sleep apnea. If your child has sleep apnea, we offer a wide range of treatment options. […] There are many ways to treat sleep apnea in kids. How we treat your child depends on: […] Sometimes sleep apnea is caused by environmental allergens. If that’s the case, dealing with the allergy is the best way to treat the apnea. It can also have added benefits. […] Sometimes apnea is the result of enlarged tonsils. When that’s the case, the best treatment option is often a tonsil removal, known as a tonsillectomy. […] Some of the ways we treat sleep apnea in kids include: […] CPAPs keep airways open by sending air through a mask. This pressure makes it easier to breathe and improves sleep quality. There are many different types of CPAP devices sized for children. We’ll work together to help you find the right device for your family. […] Dealing with it early can help your child avoid the worst side effects, like heart damage.

• #58 Obstructive Sleep Apnea in Children | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/o/obstructive-sleep-apnea-in-children.html

  How is obstructive sleep apnea treated in a child? […] The treatment for obstructive sleep apnea is based on the cause. It may include: […] Surgery to remove the enlarged tonsils and adenoids. Your childs healthcare provider will discuss the risks and benefits with you. […] Weight loss. If your child is overweight, losing weight may ease symptoms. […] Continuous positive airway pressure. While sleeping, your child wears a special mask that delivers a steady stream of air to keep their airway open. Some children may have trouble getting used to the mask. […] Rapid maxillary expansion. This is a device put in place by an orthodontist. The device widens the palate and nasal passages. […] Inhaled or intranasal steroids. These medicines may help children with mild or moderate obstructive sleep apnea caused by enlarged tonsils or adenoids. […] Staying away from secondhand smoke, indoor pollutants, and allergens. This is important for children who also have nasal congestion. Never let people smoke in your home or car.

• #59 Obstructive Sleep Apnea in Kids | UVA Health Children’s

  https://childrens.uvahealth.com/services/pediatric-sleep/sleep-apnea

  At UVA Health Childrens, our sleep specialists can diagnose obstructive sleep apnea. If your child has sleep apnea, we offer a wide range of treatment options. […] There are many ways to treat sleep apnea in kids. How we treat your child depends on: […] Sometimes sleep apnea is caused by environmental allergens. If that’s the case, dealing with the allergy is the best way to treat the apnea. It can also have added benefits. […] Sometimes apnea is the result of enlarged tonsils. When that’s the case, the best treatment option is often a tonsil removal, known as a tonsillectomy. […] Some of the ways we treat sleep apnea in kids include: […] CPAPs keep airways open by sending air through a mask. This pressure makes it easier to breathe and improves sleep quality. There are many different types of CPAP devices sized for children. We’ll work together to help you find the right device for your family. […] Dealing with it early can help your child avoid the worst side effects, like heart damage.

• #60 Pediatric Obstructive Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557610/

  Any patient with a reversible risk factor for OSA, especially obesity, should be counseled on reversing the issue. Weight loss can improve OSA and can be considered adjunctive therapy in older children. Parents should also be advised to limit children’s exposure to second-hand smoke and tobacco use in the house.

• #61 Pediatric Obstructive Sleep Apnea (OSA) | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/o/obstructive-sleep-apnea

  Weight loss: If weight is the cause of pediatric OSA, your doctor may recommend a weight loss plan. The plan may include diet changes and exercise. […] Medications: Your doctor may recommend a nasal steroid or allergy medicine. […] Your child may need to undergo a second PSG a few months after treating the pediatric obstructive sleep apnea. This second test can determine if the treatment or surgery worked. In some cases, the treatment can stop snoring but not cure pediatric OSA.

• #62 Pediatric Sleep-disordered Breathing – ENT Health

  https://www.enthealth.org/conditions/pediatric-sleep-disordered-breathing/

  Recent studies have shown that some children have persistent SDB after TA. A post-operative sleep study may be necessary, especially in children with persistent symptoms or increased risk factors for persistent apnea after TA such as obesity, craniofacial anomalies or neuromuscular problems. Additional treatments such as weight loss, the use of continuous positive airway pressure (CPAP), or additional surgical procedures may sometimes be required.

• #63 Best Practices in Pediatric Obstructive Sleep Apnea Treatment

  https://www.backtable.com/shows/ent/articles/pediatric-obstructive-sleep-apnea-treatment-best-practices

  More recent research has demonstrated that surgeries such as tonsillectomy and adenoidectomy (TNA) can be very effective at treating sleep apnea in children. In children with very mild obstructive sleep apnea, close observation and follow up is a very acceptable route as well. Sometimes waiting and letting the child grow is enough for symptoms to resolve. […] An observation may be more intensive in terms of what you do in clinic than surgical intervention. By observation, what we have done in the study is we have allowed each site to treat these kids with whatever is the standard of care in that site. […] Children who have had a TNA, yet still have persistent symptoms often have an underlying issue. Persistent OSA post-TNA is often found in children who are of normal weight but continue to have nasal problems. These children require thorough examination to identify potential issues such as adenoid regrowth, insufficient adenoid removal, or nasal obstructions.

• #64 Pediatric obstructive sleep apnea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/symptoms-causes/syc-20376196

  Pediatric obstructive sleep apnea is a condition in which a child’s breathing is partly or completely blocked during sleep. […] It’s important for healthcare professionals to find and treat pediatric obstructive sleep apnea as soon as possible. Early treatment helps prevent other health conditions called complications. These can affect children’s growth, learning, behavior and heart health. The first treatment may be surgery to remove enlarged tonsils and adenoids. But some children may get better using medical devices or taking medicines. […] Without treatment, pediatric obstructive sleep apnea can lead to other health conditions called complications. Rarely, pediatric obstructive sleep apnea can cause infants and young children not to grow as much as those who don’t have the condition. Children who don’t receive treatment also may have a higher risk of later complications such as: […] In most children, treatment can help manage complications.

• #65 Management of obstructive sleep apnea in children – UpToDate

  https://www.uptodate.com/contents/management-of-obstructive-sleep-apnea-in-children

  Management of obstructive sleep apnea in children […] Obstructive sleep apnea (OSA) is characterized by episodes of complete or partial upper airway obstruction during sleep, often resulting in gas exchange abnormalities and arousals, which disrupt sleep. The condition exists in 2 to 5 percent of children and can occur at any age. Untreated pediatric OSA is associated with behavioral and learning problems; in more severe cases, it can be associated with impaired growth (including failure to thrive) and cardiovascular complications. Early diagnosis and treatment may decrease morbidity. Treatment decisions should be made collaboratively with the patient and family and depend on findings from a comprehensive evaluation, including nighttime sleep disruption, daytime dysfunction, physical examination findings, and sleep study findings, as well as child/parent preferences. Quality measures for assessment and management of pediatric OSA have been published.

• #66 Pediatric Sleep Apnea Treatment | Dion Health TMJ

  https://tmjandsleepapneasanfrancisco.com/pediatrics/pediatric-sleep-apnea-treatment/

  At San Francisco Center for TMJ and Sleep Apnea, we take a comprehensive and multidisciplinary approach to help children achieve healthy sleep and overcome sleep apnea. […] Our experienced medical professionals specialize in pediatric sleep disorders. […] We believe that treating sleep apnea in children requires addressing the underlying causes and promoting overall well-being. […] Our team collaborates across medical disciplines, including orthodontics, dentistry, myofunctional therapy, and more. […] We offer a range of cutting-edge treatments and therapies designed to address sleep apnea in children. […] Our team at the San Francisco Center for TMJ and Sleep Apnea brings extensive expertise in treating sleep apnea in children.

• #67 Obstructive sleep apnoea | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/obstructive-sleep-apnoea/

  Nasal steroids or montelukast to clear any inflammation of the nasal passage. […] Orthodontic procedures to move the jaw forward. […] Following a weight management program if your child is overweight or obese. This would include nutritional advice, an exercise plan, and behavioural recommendations (including adequate sleep). […] Treatment of OSA in children and young people has been shown to help with learning, behaviour, and quality of life plus has long term neurodevelopmental and cardiovascular benefits.

• #68 Pediatric Obstructive Sleep Apnea Diagnosis and Treatment: What You Need to Know – Pediatrics Nationwide

  https://pediatricsnationwide.org/2024/12/18/pediatric-obstructive-sleep-apnea-diagnosis-and-treatment-what-you-need-to-know/

  Pediatric obstructive sleep apnea, a common condition in children, is definitively diagnosed with sleep studies and can be treated through various modalities, depending on disease severity. […] Medical, dental and surgical approaches are available to treat OSA, but each case requires a personalized approach. […] Medical treatments include weight loss, anti-inflammatory medications and continuous positive airway pressure (CPAP). […] Adenotonsillectomy is the first-line surgical treatment option for pediatric OSA, but other surgical approaches, such as lingual tonsillectomy, may be used. […] Overall, tailoring the treatment to the individual characteristics of the patient through shared decision-making with families can help achieve the best treatment outcomes, he concluded.

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