Sleep Disorder Breathing in Infants and Children: A review of the Literature

Dan Boboia 5/14/10 Lit. Review

Title: Sleep Disorder Breathing in Infants and Children: A review of the Literature
Author: Ivanhoe et al
Type of Article: Review

Purpose: To review etiology, diagnosis, and treatment of sleep disorder breathing in children and infants.

Methods: Peer-review lit. identified by Medline and a manual search conducted between 1999-2006. Key words for the search: children, sleep disorder, snoring, and obstructive sleep apnea. 153 manuscripts.

Summary:
· SDB (sleep disorder breathing): upper airway compromise (partial) resulting in a reduction of oxygen reaching the lungs and vascular system; common in children: 3-12% of children snore and 1-10% of them have OSA. Presence of asthma, exposure to 2nd hand smoke, and hay fever increased the incidence of snoring.
· OSA (obstructive sleep apnea): complete obstruction

For a diagnosis of OSA:
1) All children should be screened for snoring
2) Complex, high-risk pts. should be referred to a specialist
3) Patients with cardioresp. failure cannot await elective evaluation.
4) Polysomnography is the gold standard for discriminating between snoring and OSA


A delay in treatment of SDB children may be caused by several factors and may result in serious but generally reversible problems including:
· Impaired growth
· Neurocognitive and behavioral dysfunction
· Cardiorespiratory failure

Treatment of choice: adenotonsillectomy

CPAP is an option for patients who aren’t candidates for surgery or who do not respond to surgery. Minimal information is available concerning dental treatment of these disorders.

Minimal information is available concerning dental treatment of these children.