ERS statement on obstructive sleep disordered breathing in 1-to 23-month-old children

Athanasios G. Kaditis*, Maria Luz Alonso Alvarez, An Boudewyns, Francois Abel, Emmanouel I. Alexopoulos, Refika Ersu, Koen Joosten, Helena Larramona, Silvia Miano, Indra Narang, Hui-Leng Tan, Ha Trang, Marina Tsaoussoglou, Nele Vandenbussche, Maria Pia Villa, Dick Van Waardenburg, Silke Weber, Stijn Verhulst

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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.

Original languageEnglish
Article number1700985
Number of pages22
JournalEuropean Respiratory Journal
Volume50
Issue number6
DOIs
Publication statusPublished - 1 Dec 2017

Keywords

  • UPPER AIRWAY-OBSTRUCTION
  • PIERRE-ROBIN-SEQUENCE
  • MANDIBULAR DISTRACTION OSTEOGENESIS
  • MUSCULAR-ATROPHY TYPE-1
  • PRADER-WILLI-SYNDROME
  • NONINVASIVE POSITIVE-PRESSURE
  • FORAMEN MAGNUM STENOSIS
  • LIFE-THREATENING EVENTS
  • POPULATION-BASED COHORT
  • INFANT DEATH SYNDROME

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