HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Capdevila, O. S. Articles by Gozal, D. Search for Related Content PubMed PubMed Citation Articles by Capdevila, O. S. Articles by Gozal, D.

Pediatric Obstructive Sleep Apnea

Complications, Management, and Long-term Outcomes

¹ Division of Pediatric Sleep Medicine, Department of Pediatrics, University of Louisville; and ² Kosair Children's Hospital Research Institute, Louisville, Kentucky

Correspondence and requests for reprints should be addressed to David Gozal, M.D., Kosair Children's Hospital Research Institute, University of Louisville, 570 South Preston Street, Suite 204, Louisville, KY 40202. E-mail: david.gozal{at}louisville.edu

ABSTRACT

Obstructive sleep apnea (OSA) in children has emerged not only as a relatively prevalent condition but also as a disease that imposes a large array of morbidities, some of which may have long-term implications, well into adulthood. The major consequences of pediatric OSA involve neurobehavioral, cardiovascular, and endocrine and metabolic systems. The underlying pathophysiological mechanisms of OSA-induced end-organ injury are now being unraveled, and clearly involve oxidative and inflammatory pathways. However, the roles of individual susceptibility (as dictated by single-nucleotide polymorphisms), and of environmental and lifestyle conditions (such as diet, physical, and intellectual activity), may account for a substantial component of the variance in phenotype. Moreover, the clinical prototypic pediatric patient of the early 1990s has been insidiously replaced by a different phenotypic presentation that strikingly resembles that of adults afflicted by the disease. As such, analogous to diabetes, the terms type I and type II pediatric OSA have been proposed. The different manifestations of these two entities and their clinical course and approaches to management are reviewed.

Key Words: obstructive sleep apnea • adenotonsillar hypertrophy • treatment • inflammation, upper airway • snoring

This article has been cited by other articles:

				E. Goroza, M. Sagy, N. Sagy, and K. Bock Severity Assessment of Obstructive Sleep Apnea Syndrome (OSAS) in Pediatric Patients Clinical Pediatrics, June 1, 2009; 48(5): 528 - 533. [Abstract] [PDF]

				M. Castro, M. I. Ramirez, J. E. Gern, G. Cutting, G. Redding, J. S. Hagood, J. Whitsett, S. Abman, J. U. Raj, R. Barst, et al. Strategic Plan for Pediatric Respiratory Diseases Research: An NHLBI Working Group Report Proceedings of the ATS, January 15, 2009; 6(1): 1 - 10. [Abstract] [Full Text] [PDF]

				D. Gozal and L. Kheirandish-Gozal Obesity and Excessive Daytime Sleepiness in Prepubertal Children With Obstructive Sleep Apnea Pediatrics, January 1, 2009; 123(1): 13 - 18. [Abstract] [Full Text] [PDF]

				M. T. Apostolidou, E. I. Alexopoulos, K. Chaidas, G. Ntamagka, A. Karathanasi, T. I. Apostolidis, K. Gourgoulianis, and A. G. Kaditis Obesity and Persisting Sleep Apnea After Adenotonsillectomy in Greek Children Chest, December 1, 2008; 134(6): 1149 - 1155. [Abstract] [Full Text] [PDF]

				D. Gozal Matters of the Heart: The Brain in Pediatric Sleep Apnea Am. J. Respir. Crit. Care Med., October 15, 2008; 178(8): 785 - 786. [Full Text] [PDF]