Childhood obstructive sleep apnoea: an update

AM Li, DFY Chan, TF Fok, YK Wing
Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

OBJECTIVE. To review literature on epidemiology, complications, diagnosis, and treatment of childhood obstructive sleep apnoea.

DATA SOURCE. Literature search of MEDLINE up to July 2004 using the following key words: ‘obstructive sleep apnoea syndrome’, ‘children’, ‘epidemiology’, ‘complications’, ‘treatment’, and ‘polysomnography’.

STUDY SELECTION. Literature and data related to the aspects of childhood obstructive sleep apnoea.

DATA EXTRACTION. Relevant information and data were reviewed by the authors.

DATA SYNTHESIS. There is a paucity of normal data on childhood obstructive sleep apnoea. Varying definitions and diagnostic criteria have been used in different studies, making direct comparison difficult. However, a small-scale local study found that the prevalence and clinical features of this condition were similar to data published overseas. Increasing evidence suggests that childhood obstructive sleep apnoea is associated with cardiovascular morbidity and neurocognitive dysfunction. Overnight polysomnography has remained the gold standard for diagnosing obstructive sleep apnoea but the diagnostic criteria has not been standardised nor correlated with the long-term outcome. Surgical intervention has remained the treatment of choice, although alternative therapies are being evaluated.

CONCLUSION. Consensus on the various important aspects of childhood obstructive sleep apnoea is still limited, especially the definition, diagnosis, and long-term sequelae of this condition. Further advances can only be made with international collaborative research, using evidence-based definitions, standardised techniques, and polysomnographic criteria.

Hong Kong Med J 2004;10:406-13

Key words: Child; Polysomnography; Sleep apnea, obstructive