Which medications are used in the treatment of childhood obstructive sleep apnea (OSA)?

Updated: Feb 13, 2019
  • Author: Mary E Cataletto, MD; Chief Editor: Denise Serebrisky, MD  more...
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Answer

In general, medical therapy is of limited value in the typical pediatric patient with obstructive sleep apnea (OSA). Oxygen therapy should not be prescribed as the primary therapy for OSA.

Antihistamine or antimuscarinic therapy may lead to relief in cases of nasal congestion, although sustained benefit is uncertain. For allergic rhinitis or conditions associated with decreased nasal airflow, efforts to improve nasal patency may be beneficial.

An oral leukotriene modifier may eliminate residual obstructive sleep apnea following surgery, and these agents may have a role in improving clinical outcomes without surgery. Although systemic steroids do not improve obstructive sleep apnea, topical budesonide used for 6 weeks has been demonstrated to lead to a sustained improvement in mild obstructive sleep apnea. Such preparations are unproven as therapy for severe obstructive sleep apnea. Topical therapy as a primary treatment for obstructive sleep apnea remains largely investigational.

In recent years, positive-pressure ventilation administered via a noninvasive interface (nasal mask) has become a safe, efficient, and viable alternative to further surgery or tracheotomy in children and infants with unresolved obstructive sleep apnea after tonsillectomy and adenoidectomy.


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