Abstract
The present statement was produced by a European Respiratory Society Task Force to summarise the evidence and current practice on the diagnosis and management of obstructive sleep disordered breathing (SDB) in children aged 1–23 months. A systematic literature search was completed and 159 articles were summarised to answer clinically relevant questions. SDB is suspected when symptoms or abnormalities related to upper airway obstruction are identified. Morbidity (pulmonary hypertension, growth delay, behavioural problems) and coexisting conditions (feeding difficulties, recurrent otitis media) may be present. SDB severity is measured objectively, preferably by polysomnography, or alternatively polygraphy or nocturnal oximetry. Children with apparent upper airway obstruction during wakefulness, those with abnormal sleep study in combination with SDB symptoms (e.g. snoring) and/or conditions predisposing to SDB (e.g. mandibular hypoplasia) as well as children with SDB and complex conditions (e.g. Down syndrome, Prader–Willi syndrome) will benefit from treatment. Adenotonsillectomy and continuous positive airway pressure are the most frequently used treatment measures along with interventions targeting specific conditions (e.g. supraglottoplasty for laryngomalacia or nasopharyngeal airway for mandibular hypoplasia). Hence, obstructive SDB in children aged 1–23 months is a multifactorial disorder that requires objective assessment and treatment of all underlying abnormalities that contribute to upper airway obstruction during sleep.
Abstract
Obstructive sleep disordered breathing in young children is a heterogeneous group of disorders http://ow.ly/qqgc30fGvaj
Footnotes
This document was endorsed by the ERS Science Council and Executive Committee in September 2017.
This article has supplementary material available from erj.ersjournals.com
Support statement: The European Respiratory Society financially supported this Task Force (ERS Task Force 2012-09) through organisation of meetings and travel expenses of its members for the purpose of preparing the current statement. Funding information for this article has been deposited with the Crossref Funder Registry.
Conflict of interest: None declared.
- Received May 14, 2017.
- Accepted August 16, 2017.
- Copyright ©ERS 2017