Nonsurgical Management of Sleep-Disordered Breathing

A thorough assessment of sleep-disordered breathing (SDB) should include an evaluation of the effects of sleep disruption on the child’s daytime functioning and health in addition to a polysomnography. SDB is associated with significant physical, cognitive, and behavioral health problems. Children are particularly vulnerable to the effects of SDB. Many children with SDB are treated successfully with adenotonsillectomy. A few require more invasive surgery on their upper airway. However, there is a group of children that requires nonsurgical treatment for SDB. A number of variables must be taken into account when making a decision to treat or not treat a child who has documented SDB. The choice should not be based solely on the apnea-hypopnea index. The number of available masks and cannulas has increased substantially, though the availability of masks in pediatric sizes can vary regionally and from country to country.