BMJ  2005;330:978-979 (30 April), doi:10.1136/bmj.330.7498.978

Editorial

Childhood obstructive sleep apnoea

Serious neurobehavioural sequelae have prompted interest in diagnosis and management

The first 150 words of the full text of this article appear below.

Obstructive sleep apnoea is characterised by oxygen desaturation and reduced oro-nasal air flow despite preserved thoracic and abdominal respiratory effort.¹ It occurs in 1-2% of children and is more common in prematurely born infants and in black and Hispanic children.² As our knowledge of this condition has grown, so has concern about it among parents and clinicians. How is it best diagnosed and managed?

Habitual snoring, breathing through the mouth, periods of observed apnoea, restless sleep, urinary incontinence, inattentiveness, daytime hyperactivity, mood swings, and failure to thrive are the most common clinical manifestations of childhood obstructive sleep apnoea. How loudly a child snores is not correlated to the presence or severity of sleep disordered breathing. The most common predisposing factors are adenotonsillar hypertrophy, neuromuscular disorders, and craniofacial anomalies associated with maxillary hypoplasia, retrognathia, or macroglossia. The local release of proinflammatory cytokines such as C reactive protein, tumour necrosis factor . . . [Full text of this article]

Sleep Disorders Center, Division of Child Neurology, Mayo Clinic, Rochester, MN 55905, USA (kotagal.suresh@mayo.edu)

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