HealthDay News — The American Academy of Pediatrics (AAP) has released revised recommendations for the diagnosis and management of obstructive sleep apnea syndrome (OSAS) in children and adolescents. 

Carole L. Marcus, M.B.B.Ch., from the AAP’s Subcommittee on Obstructive Sleep Apnea Syndrome, and colleagues based the new recommendations on a literature review of 350 relevant articles published from 1999 to 2010, most of which were considered level II to IV grade evidence. The revised clinical practice guidelines were published online in Pediatrics.

The new guidelines state that all children and adolescents be screened for snoring, and that polysomnography be performed in those with snoring and symptoms or signs of OSAS. Adenotonsillectomy is the first-line treatment of choice for patients with adenotonsillar hypertrophy, with reevaluation recommended postoperatively to determine whether further treatment is required.

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If adenotonsillectomy is not performed or if OSAS persists postoperatively, continuous positive airway pressure (CPAP) is recommended as a treatment. For overweight or obese patients, weight loss is recommended in addition to other therapy.

For children with mild OSAS in whom adenotonsillectomy is contraindicated or for mild postoperative OSAS, intranasal corticosteroids should be considered.

“There is a great need for further research into the prevalence of OSAS, sequelae of OSAS, best treatment methods, and the role of obesity,” Marcus and colleagues wrote.


  1. Marcus CL et al. Pediatrics. 2012; doi:10.1542/peds.2012-1671.