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Pediatric Sleep II

Pediatric Sleep-Disordered Breathing

  • Chapter
Primary Care Sleep Medicine

Part of the book series: Current Clinical Practice ((CCP))

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Abstract

Sleep-disordered breathing (SDB) in children encompasses a continuum of upper airway obstruction during sleep. Intermittent snoring represents the mildest form of this disorder and appears to have few significant clinical consequences. Obstructive sleep apnea (OSA), on the other hand, represents the other extreme, with gas exchange abnormalities and sleep disruption. With the American Academy of Pediatrics Clinical Practice Guideline (published in April 2002) (1), the primary care physician gained further awareness of the need to screen for SDB, leading to increased referrals to otolaryngology and sleep specialists. The American Academy of Pediatrics guideline recommends the following:

  1. 1.

    All children should be screened for snoring.

  2. 2.

    Complex, high-risk patients should be referred to a specialist.

  3. 3.

    Patients with cardiorespiratory failure cannot await elective evaluation.

  4. 4.

    Diagnostic evaluation is useful in discriminating between primary snoring (PS) and OSA syndrome; the gold standard is polysomnography (PSG).

  5. 5.

    Adenotonsillectomy is the first line of treatment for most children, and continuous positive airway pressure (CPAP) is an option for those who are not candidates for surgery or do not respond to surgery.

  6. 6.

    High-risk patients should be monitored as inpatients postoperatively.

  7. 7.

    Patients should be reevaluated postoperatively to determine whether additional treatment is required.

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Author information

Authors and Affiliations

  1. Department of Pulmonary and Critical Care Medicine, Departments of Internal Medicine and Pediatrics, University of Kentucky, Lexington, KY

    David M. Hiestand MD,PhD

Authors
  1. David M. Hiestand MD,PhD
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Editor information

Editors and Affiliations

  1. Department of Family Practice, University of Colorado School of Medicine, Southern Colorado Family Medicine Residency, Pueblo, CO

    James F. Pagel MS, MD

  2. Comprehensive Center for Sleep Medicine Department of Pulmonary, Critical Care, and Sleep Medicine, Mount Sinai School of Medicine, New York, NY

    S. R. Pandi-Perumal MSc

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© 2007 Humana Press Inc., Totowa, NJ

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Hiestand, D.M. (2007). Pediatric Sleep II. In: Pagel, J.F., Pandi-Perumal, S.R. (eds) Primary Care Sleep Medicine. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-59745-421-6_18

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  • DOI: https://doi.org/10.1007/978-1-59745-421-6_18

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-992-5

  • Online ISBN: 978-1-59745-421-6

  • eBook Packages: MedicineMedicine (R0)

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