Latest trends in the assessment and management of paediatric snoring and sleep apnoea

Sharma, Sunita; Kanona, Hala; Kumar, Gaurav; Kotecha, Bhik

doi:10.1017/s0022215116000980

Cited by 9 publications

(14 citation statements)

References 21 publications

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“…Currently, the use of home-based studies is not recommended in the diagnosis of pediatric OSA [11]; however, there remains utilization of home-based sleep oximetry, possibility as a result of the resource scarcity that is seen in many care settings [14, 15]. Our study showed that there is variability with which home-based sleep oximetry is ordered and interpreted among surgeons.…”

Section: Discussionmentioning

confidence: 87%

“…Notwithstanding, our institution has observed the ongoing use of home-based sleep oximetry, both in public and private care settings. A review of the recent literature suggests that many clinicians are still using this modality as part of their standard approach to children referred for OSA [12–15]. In a survey of National Health Services otolaryngology departments in the UK, 84% of respondents reported using pre-operative pulse oximetry and among these practitioners, 58% used home-based sleep oximetry [15].…”

Section: Introductionmentioning

confidence: 99%

“…A review of the recent literature suggests that many clinicians are still using this modality as part of their standard approach to children referred for OSA [12–15]. In a survey of National Health Services otolaryngology departments in the UK, 84% of respondents reported using pre-operative pulse oximetry and among these practitioners, 58% used home-based sleep oximetry [15]. The continued use of home-based sleep oximetry likely reflects the lack of access to PSG that is seen in many care settings, predominately in publicly funded health systems.…”

Section: Introductionmentioning

confidence: 99%

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Overnight oximetry in children undergoing adenotonsillectomy: a single center experience

Liu

Chaput

Kirk

et al. 2019

J of Otolaryngol - Head & Neck Surg

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BackgroundObstructive sleep apnea (OSA) is the most common indication for adenotonsillectomy in children. Home-based sleep oximetry continues to be used in the diagnosis of pediatric OSA despite a lack of correlation with lab-based polysomnography. This study investigates whether factors influence surgeons in selecting patients for home-based sleep oximetry, how the study findings are used in patient management, and whether abnormal oximetry findings are associated with post-operative complications.MethodsA retrospective review was performed on children with suspected OSA who had undergone a tonsillectomy and/or an adenoidectomy over a three-year period. Demographic features, comorbidities, pre-operative oximetry results, and post-operative complications were recorded. Data analysis consisting primarily of logistic regression was performed using Stata 12.0 (College Station, Texas).ResultsData was collected from 389 children. Two hundred and seventy-one children underwent pre-operative oximetry (69.7%). There was no significant association between age or the presence of comorbidities and the likelihood of undergoing pre-operative sleep oximetry. The post-operative complication rate was 0.8%. There was no significant association between abnormal sleep oximetry parameters and post-operative complications. Children with one or more abnormal sleep oximetry parameters were more likely to be observed in hospital for at least one night (OR 2.4, p < 0.0001).ConclusionsOur study suggests that surgeons are using home-based sleep oximetry findings to inform the post-operative care of children with suspected OSA, as those with abnormal home-based sleep oximetry findings were more likely to be observed in hospital. These hospital admissions may be unnecessary given the poor correlation of home-based oximetry and PSG as well as the low rate of serious post-operative complications.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Overnight oximetry in children undergoing adenotonsillectomy: a single center experience

Liu

Chaput

Kirk

et al. 2019

J of Otolaryngol - Head & Neck Surg

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“…In particular, CPAP is recommended for the treatment of uncomplicated moderate to severe OSA, while it remains optional in mild OSA 72 , since its use has been associated with: (i) reduction of sleep fragmentation, daytime sleepiness and cardiovascular risk, and (ii) improved neurocognitive performances and quality of life 73 . In the paediatric population, CPAP has been reported to be useful in selected cases: (i) patients not eligible for surgery, (ii) patients waiting for interventions, (iii) patients with persisting disease after surgery 74 , and (iv) patients with other diseases, such as Down’s syndrome or craniofacial anomalies 75 .…”

Section: Discussionmentioning

confidence: 99%

Assessment of obstructive sleep apnoea (OSA) in children: an update

Savini

Ciorba

Bianchini

et al. 2019

Acta Otorhinolaryngol Ital

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SUMMARYOSA is a condition characterised by episodes of complete or partial obstruction of the upper airway, associated with blood-gas changes and atypical sleep patterns. Early diagnosis of OSA may reduce the occurrence of systemic complications over time, although the diagnosis of OSA is, unfortunately, often late. The aim of the work is to review the current concepts in evaluation of paediatric obstructive sleep apnoea (OSA), with an updated revision of the literature considering risk factors, clinical manifestations, and basic and advanced assessment in the paediatric population. For this narrative review, PubMed, Embase and Cinahl databases were searched for the last 10 years, according to PRISMA criteria/guidelines. Assessment of paediatric OSA remains challenging and paediatric patients should always be carefully evaluated; polysomnography is the gold standard for diagnosis of paediatric OSA.

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“…interesting topic, notably those concerning cardiopulmonary aspects of paediatric OSA, 3 the assessment of paediatric OSA, 4 tonsillotomy versus tonsillectomy, 5 and the use of adenoidectomy alone. 6 These two reviews cover such controversies as tonsillotomy versus tonsillectomy, anaesthetic considerations, postoperative monitoring, determination of when a threshold is reached at which treatment is required, and the wider medical aspects of sleep apnoea in children.…”

mentioning

confidence: 99%

A focus on paediatric obstructive sleep apnoea

Fisher¹,

Youngs²,

Hussain³

et al. 2018

J. Laryngol. Otol.

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Latest trends in the assessment and management of paediatric snoring and sleep apnoea

Abstract: There is variation in the assessment and management of paediatric snoring and obstructive sleep apnoea across the UK, particularly in the use of pre- and post-operative pulse oximetry monitoring, and further guidelines regarding this are necessary.

Cited by 9 publications

References 21 publications

Overnight oximetry in children undergoing adenotonsillectomy: a single center experience

Overnight oximetry in children undergoing adenotonsillectomy: a single center experience

Assessment of obstructive sleep apnoea (OSA) in children: an update

A focus on paediatric obstructive sleep apnoea

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