Younger children (1– 23 months) | Older children (2–18 years) | |
Diagnosis | ||
Symptoms reflecting upper airway obstruction are frequently present both during wakefulness and sleep | Yes | No |
Adenotonsillar hypertrophy and obesity predominantly cause SDB | No | Yes |
Various congenital, syndromic and/or genetic entities predominantly cause SDB | Yes | No |
Feeding difficulties and growth failure may coexist with OSAS | Yes | No |
Pulmonary hypertension may complicate OSAS, especially in patients with complex conditions | Yes | Yes |
Polysomnography is the gold standard for diagnosis of OSAS | Yes | Yes |
Endoscopy is especially useful to determine the level of upper airway collapse | Yes | No |
Management | ||
Adenotonsillectomy is the most commonly used treatment | No | Yes |
NPPV is frequently used as first-line treatment due to a high incidence of multilevel, dynamic airway collapse | Yes | No |
Orthodontic appliances are effective in cases of OSAS with retrognathia or malocclusion | No | Yes |
Patients with complex conditions are prioritised for treatment | Yes | Yes |
Follow-up after each treatment intervention may identify persistent OSAS | Yes | Yes |
Patients on NPPV undergo nocturnal cardiorespiratory monitoring annually | Yes | Yes |
OSAS: obstructive sleep apnoea syndrome; NPPV: non-invasive positive pressure ventilation.