title: Current practice patterns for sleep-disordered breathing in children.
abstract: OBJECTIVE
  Since the primary therapy for children with sleep-disordered breathing(SDB) is adenotonsillectomy, a survey was developed to determine the current practice patterns for children with SDB by pediatric otolaryngologists.
  
  
  METHODS
  Cross-sectional survey
  
  
  METHODS
  An Internet-based survey was sent to all American Society of Pediatric Otolaryngology members. In addition to descriptive statistics, a logistic regression was performed to assess if years in practice, polysomnogram (PSG) wait time, or frequency of evaluating snoring children changes management.
  
  
  RESULTS
  The response rate was 39% (135/345). Children with SDB were "most of the time" referred for PSGs by 4% of respondents. Sixty-five percent referred for PSG "sometimes," and 31% referred "rarely" or "never." An increased wait time was a significant predictor of PSG frequency (OR = 1.10, 95% CI: 0.92-1.0, P = 0.039). Children with Down syndrome or obesity had preoperative PSG requested "always" 20% and 8% of the time. The primary reason for requesting a PSG in a normal child was inconsistent clinical evaluation (58%). To diagnose obesity, most (72%) record height and weight, but only 34% record BMI% for age. Overnight observation was performed "most of the time" for the following groups: Obese (70%), Down syndrome (83%), and <3 years (83%).
  
  
  CONCLUSIONS
  Pediatric otolaryngologists are noncompliant with the 2002 American Academy of Pediatrics and the 2011 American Academy of Otolaryngology-Head and Neck Surgery guidelines. Despite noncompliance, they fortunately have a lower threshold to monitor high-risk children overnight following surgery. The recommended Center for Disease Control measures to diagnose childhood obesity occasionally are being utilized. An educational campaign is necessary to update clinicians who take care of children on the new evidence-based guidelines.
authors: Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO 80045, USA. Norman.Friedman@childrenscolorado.org
authors: Norman R
authors: NR
authors: Friedman
authors: Jonathan N
authors: JN
authors: Perkins
authors: Bryan
authors: B
authors: McNair
authors: Ron B
authors: RB
authors: Mitchell
mesh_terms: D000233:Adenoidectomy; D002648:Child; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D017286:Polysomnography; D010818:Practice Patterns, Physicians'; D011364:Professional Practice; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000628:therapy*; D012913:Snoring / Q000175:diagnosis / Q000628:therapy; D014068:Tonsillectomy