Treatments for Pediatric
OSA (Obstructive Sleep Apnea) is one of the most sleep disorders around, even in pediatrics. The main treatment for OSA in Pediatrics is a TnA (Tonsillectomy and Adenoidectomy). However, it is important to note that only 2-3% of the Pediatric population has OSA, yet 10% of the Pediatric population has BPS (Benign Primary Snoring). PSG (Polysomnogram) is the Gold Standard for differentiating between OSA and BPS. Also, medical management of OSA may include use of Nasal Steroid and/or Leukotrine Inhibitors.
In children with OSA that TnA is deemed to be either not safe or not indicated another option is CPAP. This is a tried and true treatment for children and adults, and is further discussed in our adult treatments post.
Treatment of childhood obstructive sleep apnea syndrome (OSAS) with positive airway pressure (PAP) therapy improves a number of important neurobehavioral outcomes. Improvements were seen despite suboptimal adherence with treatment and were observed in a heterogeneous group of children, many with underlying medical conditions and/or developmental delays. PAP treatment was associated with significant improvements in attention deficits, behavior, sleepiness, and caregiver- and child-reported quality of life. This suggests that PAP use should be encouraged in children with OSAS, even in those with suboptimal adherence, as it can lead to improvements in function that can in turn affect family, social and school function. (American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine. 2012)
Despite suboptimal compliance on CPAP, there is still evidence and recommendation to continue treatment. Treatment of childhood obstructive sleep apnea syndrome (OSAS) with positive airway pressure (PAP) therapy improves a number of important neurobehavioral outcomes. Improvements were seen despite suboptimal adherence with treatment and were observed in a heterogeneous group of children, many with underlying medical conditions and/or developmental delays. PAP treatment was associated with significant improvements in attention deficits, behavior, sleepiness, and caregiver- and child-reported quality of life. This suggests that PAP use should be encouraged in children with OSAS, even in those with suboptimal adherence, as it can lead to improvements in function that can in turn affect family, social and school function. (American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine. 2012)
Another treatment for OSA is RPE (Rapid Palatal Expansion) and is a process of expanding the palate to increase in the diameter of airway. Maxillary constriction leads to increased nasal resistance and resultant mouth-breathing and is associated with alterations in tongue posture which could result in retroglossal airway narrowing. Both are features typically seen in OSA. RPE increases the width of the maxilla and reduces nasal resistance.
Other options for individualized therapy for OSA may include medical management with use of nasal steroid and leukotriene inhibitors, positional sleeping, and weight loss.
