American Academy of Pediatrics Updates OSA Guidelines

The American Academy of Pediatrics (AAP) is revising its recommendations for the diagnosis and management of obstructive sleep apnea syndrome (OSAS) in children and adolescents, according to a clinical practice guideline published online in Pediatrics.

An updated clinical practice guideline from the American Academy of Pediatrics spells out which children with obstructive sleep apnea syndrome who undergo adenotonsillectomy should be admitted as inpatients.

Read Abstract Diagnosis and Management of Obstructive Sleep Apnea Syndrome

The first recommendation in the updated guideline advises clinicians to screen for OSAS during routine health maintenance visits, because OSA in children is underdiagnosed, stated Dr. Carole L. Marcus, Director Sleep Center at the Children’s Hospital of Philadelphia and chair of the subcommittee that assembled the guideline. Parents don’t necessarily think of snoring as a sign of a serious disease. They might think it’s funny, but it’s actually a sign of illness.

The guideline also recommends that the following subset of children be admitted as inpatients after tonsillectomy: those younger than age 3; those with severe OSAS on polysomnography; those with cardiac complications of OSAS; those with failure to thrive; those who are obese; and those with craniofacial anomalies, neuromuscular disorders, or a current respiratory infection.

Another component to the guideline is the recommendation that clinicians refer patients for continuous positive airway pressure (CPAP) management if OSAS signs and symptoms persist after adenotonsillectomy or if adenotonsillectomy is not performed.

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