Teams of pediatric specialists often collaborate in the care of infants and children with sleep apnea. Members of the following specialty groups have specific expertise that may help the primary care physician coordinate the care of their patient with sleep apnea:
-
Pediatric sleep medicine
-
Pediatric otolaryngology
-
Pediatric plastic surgery
-
Orthognathic surgery
-
Pediatric neurosurgery
-
Pediatric anesthesia
-
PICU
-
Pediatric endocrinology
-
Pediatric pulmonology
-
Pediatric cardiology
For the otherwise healthy child with enlarged tonsils and adenoids, consultation with a pediatric sleep specialist and referral to a pediatric sleep laboratory for diagnosis are usually sufficient.
When findings support the existence of obstructive sleep apnea, refer the patient to a pediatric otolaryngologist for adenotonsillectomy and take appropriate perioperative and postoperative precautions in higher-risk groups. When obesity is present, refer the patient to a nutritional intervention program. Similarly, pursue echocardiography and input from a pediatric cardiologist when pulmonary hypertension is clinically suspected.
When craniofacial syndromes or neuromuscular disorders are the major cause of obstructive sleep apnea, a multidisciplinary approach is mandatory for improved outcomes.
-
Palate appearance following uvulopalatopharyngoplasty (UPPP) surgery.
-
Example of an obstructive apnea and an obstructive hypopnea recorded during polysomnography.
-
Medical complications associated with obstructive sleep apnea in children.
-
Compressed overnight polysomnography tracing of a 6-year-old boy who snores, showing multiple events of obstructive apnea (green-shaded areas) associated with oxyhemoglobin desaturation (yellow-shaded areas) and EEG arousals (red-shaded areas).
-
Parameters monitored during an overnight pediatric sleep study.
-
Normal parameters for sleep gas exchange and gas exchange in children.
