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Latest trends in the assessment and management of paediatric snoring and sleep apnoea

Published online by Cambridge University Press:  20 April 2016

S D Sharma ,
H Kanona ,
G Kumar  and
B Kotecha
S D Sharma*
Affiliation:
Department of Otorhinolaryngology, Queen's Hospital, Romford, UK
H Kanona
Affiliation:
Department of Otorhinolaryngology, Queen's Hospital, Romford, UK
G Kumar
Affiliation:
Department of Otorhinolaryngology, Queen's Hospital, Romford, UK
B Kotecha
Affiliation:
Department of Otorhinolaryngology, Queen's Hospital, Romford, UK
*
Address for correspondence: Mr Sunil Sharma, Department of Otorhinolaryngology, Queen's Hospital, Rom Valley Way, Romford RM7 0AG, UK Fax: +44 (0)1708 435 096 E-mail: sunilsharma@doctors.org.uk
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Abstract

Objective:

To investigate the assessment and management of paediatric snoring and obstructive sleep apnoea in UK otolaryngology departments.

Method:

A telephone questionnaire survey of UK otolaryngology departments was conducted over a 16-week period.

Results:

The response rate was 61 per cent (85 out of 139 trusts). Use of pre-operative pulse oximetry was reported by 84 per cent of respondents, mainly to diagnose obstructive sleep apnoea (73 per cent) or stratify post-operative risk (46 per cent). Thirty-one per cent of respondents reported using post-operative pulse oximetry. Twenty-five per cent of respondents have a dedicated management protocol for paediatric obstructive sleep apnoea and snoring. Thirty-four per cent require prior clinical commissioning group approval before performing surgery. Fifty-eight per cent of respondents reported following up their obstructive sleep apnoea patients after surgery. The mean follow-up period (±standard deviation) was 6.8 ± 1.2 weeks.

Conclusion:

There is variation in the assessment and management of paediatric snoring and obstructive sleep apnoea across the UK, particularly in the use of pre- and post-operative pulse oximetry monitoring, and further guidelines regarding this are necessary.

Keywords

Obstructive Sleep Apnea SyndromePediatricsPulse Oximetry
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 5 , May 2016 , pp. 482 - 489
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 American Thoracic Society. Standards and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med 1995;153:866–78Google Scholar
2 Kanona, H, Sharma, SD, Chaidas, K, Kotecha, B. Pulse oximetry in paediatric obstructive sleep apnoea – is it used appropriately? J Laryngol Otol 2015;129:874–81Google Scholar
3 Anuntaseree, W, Rookkapan, K, Kuasirikul, P, Thongsuksai, P. Snoring and obstructive sleep apnoea in Thai school-age children: prevalence and predisposing factors. Pediatr Pulmonol 2001;32:222–7Google Scholar
4 Brunetti, L, Rana, S, Lospalluti, ML. Prevalence of obstructive sleep apnoea syndrome in a cohort of 1,207 children of Southern Italy. Chest 2001;120:1930–5CrossRefGoogle Scholar
5 Marcus, CL, Brooks, LJ, Draper, KA, Gozal, D, Halbower, AC, Jones, J et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 2012;130:576–84CrossRefGoogle ScholarPubMed
6 Robb, PJ, Bew, S, Kubba, H, Murphy, N, Primhak, R, Rollin, AM et al. Tonsillectomy and adenoidectomy in children with sleep-related breathing disorders: consensus statement of a UK multidisciplinary working party. Ann R Coll Surg Engl 2009;91:371–3CrossRefGoogle ScholarPubMed
7 Nixon, GM, Kermack, AS, Davis, GM, Manoukian, JJ, Brown, KA, Brouillette, RT. Planning adenotonsillectomy in children with obstructive sleep apnea: the role of overnight pulse oximetry. Pediatrics 2004;113:19–25 Google Scholar
8 Brouillette, RT, Morielli, A, Leimanis, A, Waters, KA, Luciano, R, Ducharme, FM. Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep apnea. Pediatrics 2000;105:405–12Google Scholar
9 Roland, PS, Rosenfeld, RM, Brooks, LJ, Friedman, NR, Jones, J, Kim, TW et al. Clinical practice guideline: polysomnography for sleep-disordered breathing prior to tonsillectomy in children. Otolaryngol Head Neck Surg 2011;145:S1–15 Google Scholar
10 Pringle, MB, Natesh, BG, Buchanan, EM. National UK survey on the assessment and surgical management of suspected paediatric obstructive sleep apnoea syndrome. Int J Pediatr Otorhinolaryngol 2013;77:1689–96Google Scholar
11 Weatherly, RA, Mai, EF, Ruzicka, DL, Chervin, RD. Identification and evaluation of obstructive sleep apnea prior to adenotonsillectomy in children: a survey of practice patterns. Sleep Med 2003;4:297–307 Google Scholar
12 GraphPad Software. QuickCalcs. In: http://www.graphpad.com/quickcalcs/contingency1/ [22 November 2015]Google Scholar
13 McColley, SA, April, MM, Carroll, JL, Naclerio, RM, Loughlin, GM. Respiratory compromise after adenotonsillectomy in children with obstructive sleep apnoea. Arch Otolaryngol Head Neck Surg 1992;18:940–3CrossRefGoogle Scholar
14 Gupta, S, Nicoli, T, Kotecha, B. Latest trends in the assessment and surgical management of snoring in England: a prospective questionnaire study. Clin Otolaryngol 2014;39:177–82CrossRefGoogle Scholar
15 Constatin, E, Tewfik, TL, Brouillette, RT. Can the OSA-18 quality-of-life questionnaire detect obstructive sleep apnea in children? Pediatrics 2010;125:162–8Google Scholar
16 Caulfield, H. Investigations in paediatric obstructive sleep apnoea: do we need them? Int J Pediatr Otorhinolaryngol 2003;67:S107–10Google Scholar
17 Myatt, HM, Beckenham, EJ. The use of diagnostic sleep nasendoscopy in the management of children with complex upper airway obstruction. Clin Otolaryngol Allied Sci 2000;25:200–8CrossRefGoogle ScholarPubMed
18 Stradling, JR, Thomas, G, Warley, AR, Williams, P, Freeland, A. Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children. Lancet 1990;335:249–53CrossRefGoogle ScholarPubMed
19 Palombini, L, Pelayo, R, Guilleminault, C. Efficacy of automated continuous positive airway pressure in children with sleep-related breathing disorders in an attended setting. Pediatrics 2004;113:e412–17 CrossRefGoogle Scholar
20 Girbal, IC, Goncalves, C, Nunes, T, Ferreira, R, Pereira, L, Saianda, A et al. Non-invasive ventilation in complex obstructive sleep apnea – a 15-year experience of a pediatric tertiary center. Rev Port Pneumol 2014;20:146–51Google Scholar
21 Nishmura, T, Morishima, N, Hasegawa, S, Shibata, N, Iwanaga, K, Yagisawa, M. Effect of surgery on obstructive sleep apnea. Acta Otolaryngol Suppl 1996;523:231–3Google Scholar