What is the role of nasal steroids in childhood obstructive sleep apnea (OSA) treatment?

Updated: Feb 13, 2019
  • Author: Mary E Cataletto, MD; Chief Editor: Denise Serebrisky, MD  more...
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Nasal steroids offer an opportunity to reduce obstructive events pending surgery or can be an alternative remedy for children with mild disease whose parents are reluctant to pursue surgical treatment. [22]

Steroids are not shown to decrease obstructive symptoms, eliminate the need for surgery, prevent oxygen desaturation, or shrink tonsil or adenoid tissue.

No long-term studies are available to assess the duration of steroid effect, and whether beneficial aspects persist even if therapy is continued is unknown.

A trial of topical steroid therapy should not delay surgical treatment of obstructive apnea in children with severe tonsillar hypertrophy or moderate-to-severe obstructive sleep apnea.

No studies have assessed the efficacy of topical steroid therapy in children with craniofacial abnormalities and obstructive sleep apnea.

Short courses of systemic steroids (prednisone, 1 mg/kg/d PO for 5 d) have been shown to be ineffective in the treatment of childhood obstructive sleep apnea due to tonsil or adenoid hypertrophy.

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