TY - JOUR
TI - ERS statement on obstructive sleep disordered breathing in 1- to 23-month-old children
AU - Kaditis, A.G.
AU - Alvarez, M.L.A.
AU - Boudewyns, A.
AU - Abel, F.
AU - Alexopoulos, E.I.
AU - Ersu, R.
AU - Joosten, K.
AU - Larramona, H.
AU - Miano, S.
AU - Narang, I.
AU - Tan, H.-L.
AU - Trang, H.
AU - Tsaoussoglou, M.
AU - Vandenbussche, N.
AU - Villa, M.P.
AU - Waardenburg, D.V.
AU - Weber, S.
AU - Verhulst, S.
JO - The European respiratory journal
PY - 2017
VL - 50
TODO - 6
SP - null
PB - European Respiratory Society
SN - null
TODO - 10.1183/13993003.00985-2017
TODO - corticosteroid;  montelukast, achondroplasia;  adenoidectomy;  adenotonsillectomy;  age distribution;  apnea;  apnea hypopnea index;  Article;  atresia;  Beckwith Wiedemann syndrome;  Budd Chiari syndrome;  clinical effectiveness;  cloanal atresia;  cor pulmonale;  dehydration;  diagnostic value;  disease predisposition;  disease severity;  Down syndrome;  drug efficacy;  drug tolerability;  endoscopy;  human;  hypoxemia;  image analysis;  larynx spasm;  mucopolysaccharidosis;  oxygen saturation;  physical examination;  polysomnography;  positive end expiratory pressure;  Prader Willi syndrome;  predictive value;  prevalence;  priority journal;  prognosis;  pulmonary hypertension;  pulse oximetry;  risk factor;  sensitivity and specificity;  sleep disordered breathing;  snoring;  thorax radiography;  tracheostomy;  treatment response;  x-ray computed tomography;  advisory committee;  complication;  Europe;  infant;  medical society;  oximetry;  practice guideline;  severity of illness index;  sleep disordered breathing;  snoring;  tonsillectomy, Adenoidectomy;  Advisory Committees;  Continuous Positive Airway Pressure;  Down Syndrome;  Europe;  Humans;  Infant;  Oximetry;  Polysomnography;  Practice Guidelines as Topic;  Prader-Willi Syndrome;  Severity of Illness Index;  Sleep Apnea, Obstructive;  Snoring;  Societies, Medical;  Tonsillectomy
TODO - 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. Copyright © ERS 2017.
ER -