Sleep studies may affect treatment decisions in children with sleep breathing disorders

New study recommends that healthy children with symptoms of sleep-breathing disorders, such as snoring or temporarily stopping breathing, should consider having a sleep study (polysomnography) and should discuss the benefits potential of this with their pediatrician or otolaryngologist to possibly manage the child’s symptoms. medically and before surgery.

Sleeping breathing disorders are common in children and range from mild snoring to severe sleep apnea. Doing a sleep study provides more information on the severity of the disease. Doctors often suggest adenotonsillectomy (removal of adenoids and tonsils) to improve the condition. There are conflicting guidelines on the potential benefits of sleep studies.

To determine the prevalence and characteristics of children with normal elective sleep studies for obstructive sleep-related breathing disorder, researchers performed a retrospective study of patients aged two to 18 who underwent diagnostic polysomnography for respiratory disorders. of sleep between 2012 and 2018.

We found that many children (44.7%) who, in theory, would perform surgery without a preoperative sleep study if guidelines were strictly followed, had normal sleep studies, which might call into question the need surgery.

Michael Cohen, MD, Corresponding Author, Assistant Professor of Otorhinolaryngology-Head Surgery, Boston University School of Medicine

They also found that Caucasian children, children over the age of four, children without respiratory symptoms other than snoring, and children with smaller tonsils were more likely to have normal sleep studies.

According to co-author Jessica Levi, MD, associate professor of otolaryngology and pediatrics at BUSM, this research shows that obtaining sleep studies can affect management decisions about whether to undergo an adenotonsillectomy or medically manage the child’s symptoms. “The potential delays in care and the costs associated with obtaining polysomnography must be weighed against the concerns of parents and the possibility that the outcome may change management. These factors should be discussed with each patient’s family for the purpose of shared decision-making, ”adds Levi, who is also director of pediatric otolaryngology at Boston Medical Center.

These results appear online in the journal Annals of Otology, Rhinology and Laryngology.