Non-surgical management of obstructive sleep apnoea: a review.

BACKGROUND

Obstructive sleep apnoea is common in children and, if untreated, can lead to multiple medical sequelae. The Childhood Adenotonsillectomy Trial demonstrated benefit from early surgical intervention, but rapid access to such treatment is not always available.

AIMS

To examine the recent literature on non-surgical aspects of the management of paediatric obstructive sleep apnoea (OSA).

METHODS

The English language literature was searched for articles on the conservative management of OSA.

RESULTS

In mild cases of OSA, intra-nasal steroids and other anti-inflammatory medications may give relief in mild cases of OSA, but the long-term safety of these treatments has not been established. Weight loss in obese children has been shown to be effective in selected patients but is limited in practice. Non-invasive ventilation may be effective but compliance can be a major obstacle. Oral appliances are effective by stenting the pharyngeal airway, but research in this area is limited.

CONCLUSIONS

There are number of potential, if not proven, alternative management strategies for children with OSA, which could be considered in the absence of early surgical intervention.