Diagnosis and Treatment of Sleep Apnea in Children: A Future Perspective Is Needed

Abstract

Obstructive sleep apnea (OSA) in children is a prevalent, but still, today, underdiagnosed illness, which consists of repetitive episodes of upper airway obstruction during sleep with important repercussions for sleep quality. OSA has relevant consequences in the pediatric population, mainly in the metabolic, cardiovascular (CV), and neurological spheres. However, contrary to adults, advances in diagnostic and therapeutic management have been scarce in the last few years despite the increasing scientific evidence of the deleterious consequences of pediatric OSA. The problem of underdiagnosis and the lack of response to treatment in some groups make an update to the management of OSA in children necessary. Probably, the heterogeneity of OSA is not well represented by the classical clinical presentation and severity parameters (apnea/hypopnea index (AHI)), and new strategies are required. A specific and consensus definition should be established. Additionally, the role of simplified methods in the diagnosis algorithm should be considered. Finally, the search for new biomarkers for risk stratification is needed in this population. In conclusion, new paradigms based on personalized medicine should be implemented in this population.

This work was supported by funds received by the ISCIII (PI18/00565 and PI22/01653), the Spanish Respiratory Society (Sociedad Española de Neumología y Cirugía Torácica—SEPAR) (535-2018 and 1073-2020), and an unconditioned research grant from Menarini Laboratories and NEUMOMADRID (Sociedad Madrileña de Neumología y Cirugía Torácica).