title: When and why to treat the child who snores?
abstract: Obstructive sleep-disordered breathing (SDB) can result in cardiovascular and neurocognitive morbidity as well as adversely affect behavior, growth, quality of life, and nocturnal continence. This article summarizes the latest evidence regarding the morbidity related to obstructive SDB, commenting on the impact of severity of obstruction, that is, the difference in effects seen of moderate to severe obstructive sleep apnea syndrome (OSAS) compared to those of mild OSAS or primary snoring. The impact of therapy is discussed, focusing on which children are likely to benefit from treatment interventions; namely those with moderate or severe OSAS irrespective of the presence of morbidity, children with mild OSAS with associated morbidity or predictors of SDB persistence such as obesity, and children with complex conditions accompanied by upper airway obstruction like craniosynostosis and Prader-Willi syndrome. The co-existing conditions which may improve when treatment for obstructive SDB is offered are reviewed, while the clinical parameters associated with spontaneous improvement or resolution of obstructive SDB are discussed. The intention being to enable clinicians to make informed decisions on who should be treated, when and why. Pediatr Pulmonol. 2017;52:399-412. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Pediatric Respiratory Medicine, Royal Brompton Hospital, Sydney St., London SW3 6NP, United Kingdom.
authors.forename: Hui-Leng
authors.initials: HL
authors.lastname: Tan
authors.affiliation: Multidisciplinary Sleep Unit, Pulmonology, University Hospital of Burgos and CIBER of Respiratory Diseases (CIBERES), Burgos Foundation for Health Research, Burgos, Spain.
authors.forename: Maria Luz
authors.initials: ML
authors.lastname: Alonso Alvarez
authors.affiliation: Pediatric Pulmonology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece.
authors.forename: Marina
authors.initials: M
authors.lastname: Tsaoussoglou
authors.affiliation: Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Botucatu Medical School, São Paulo State University-UNESP, Botucatu, São Paulo, Brazil.
authors.forename: Silke
authors.initials: S
authors.lastname: Weber
authors.affiliation: Pediatric Pulmonology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece.
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Kaditis
mesh_terms: D000233:Adenoidectomy; D001249:Asthma / Q000150:complications; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology; D017704:Baroreflex / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology; D060825:Cognitive Dysfunction / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D006130:Growth Disorders / Q000209:etiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications; D053206:Nocturnal Enuresis / Q000209:etiology; D010033:Otitis Media / Q000150:complications; D011788:Quality of Life; D012135:Respiratory Sounds; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012913:Snoring / Q000209:etiology / Q000628:therapy*; D013318:Stroke Volume / Q000502:physiology; D014068:Tonsillectomy
keywords: adenotonsillectomy; obesity; primary snoring