Pediatric obstructive sleep apnea: an update.

Obstructive Sleep Apnea
Name
Institution Affiliation
OBSTRUCTIVE SLEEP APEA
The main idea is to come up with a clinical guideline, intended for evaluation, diagnosis management of Obstructive Sleep Apnea syndrome among school going children. Pediatric Obstructive Sleep Apnea (OSA) is a common condition that can have an adverse effect if not treated.
Obstructive Sleep Apnea (OSA) is an inhalation disorder associated with young children during sleep. The disease is characterized by prolonged partial airway that interrupts normal ventilation during sleep. Other symptoms include abnormal breathing, habitual snoring, frequent nightmares and restlessness. In the year 2002, professionals in the American School of Pediatrics tried to come up with a clinical practice guideline on how to manage and diagnose OSA. However, since then there has not been a clear guidance to the health practitioners on evaluation criteria and treatment of snoring child. It is estimated that about 7% of school going children snores about three times per week. This condition is known as habitual snoring. According to survey data conducted by over 6,000 children, habitual snoring has been related to poor temper and low mental capacity. Additionally, snoring has also been associated with high blood pressure and neurosis. (Farber, Schechter, & Marcus, 2002)
Pediatric OSA occurs to children in various stages of development, but it is most common to school going, pupils.

It occurs correspondingly among young boys and girls. When it is not treated, children are more likely to suffer from poor learning and behavioral problems. There are various scientific methods used to diagnose pediatric OSA. They include historical and physical examination, audio taping, videotaping, pulse oximetry and abbreviated polysomnography.
In many world societies, snoring has never been regarded as a health problem or a disease. Moreover, many parents do not report any symptom to doctors hence children are not taken care of at tender stage. Thus health practitioners should do a regular check up to children during consistent health visits. Once this problem has been identified, various measures must be taken. Unfortunately, the inability to diagnose this issue is as a result of few trained and experienced specialists. Moreover, there are very few medical centers that are in the position to treat Pediatric Obstructive Sleep Apnea. These challenges are more likely to affect comprehensive pediatric sleep medicines evaluations. Once habitual snoring problem has been identified among children, next step, the patient should be referred to a doctor who is board licensed in sleep medicine. If such a physician is not available, the patient should be directed to a practitioner who has undergone requisite training or has broad experience to provide necessary guidance to the next stage of evaluation and expertise. In China, a study has shown that children treated for this problem in their tender age, they have improved significantly in later stages of development. Thus the society should be more educated that habitual snoring is a health issue, and affected children should be put on medication. (Farber, Schechter, & Marcus, 2002) Clinical diagnosis of obstructive sleep is much more reliable. However, very high standard of evaluation is needed in overnight polysomnography. This treatment involves constant positive airway pressure and also encouraging weight loss among obese children. Children that are linked with the craniofacial disease should be checked instantly in the hospital.
When habitual snoring is treated on time, 71 % of the children improved their sleep behavior and also their quality of life. Polysomnographic criteria for evaluating respiratory effects among children were profoundly revised in 2007 by American Academy of Sleep Medicine. This guideline stated that obstructive apnea lasts up to two respiratory efforts. This means that 90 percent fall in nasal pressure from the body is almost equal to 90 % of all respiratory events when equated to pre-event baseline amplitude. It is argued that hypopneas must stay for double baseline breath with a decrease in the magnitude of nasal pressure of alternative signal that is equivalent to 50 % baseline airflow.
There is a big relationship between increasing obesity and sleep-disordered breathing in children. There is a very high population of children with obesity has sleep disorders. Obstructive Sleep Apnea is seen in both obese and non-obese kids. However, obese children are at increased danger of contracting obstructive Sleep Apnea. This is the reason as to why many obese children will have excessive daytime sleepiness than the non-obese kids. Doctors should be very keen when treating obese children suffering from obstructive sleep apnea. (Loghmanee, & Sheldon, 2010) Aden tonsillectomy treatment has been associated with an increase in body mass when it is used to treat obese children. The physician is supposed to follow up the child and also ensure that he put emphasis on the weight loss. Alternatively, the doctor can use other options to treat obstructive sleep apnea among obese patients. The differences in impediment rate and treatment response among obese patients paralleled to those who have reasonable weight make their level of evaluation more complicated.
Aden tonsillectomy is a treatment used to treat obstructive sleep apnea. This methodology has been used to treat almost 71 % of children. It has helped to improve the quality of life and sleep behavior. However, adenotonsnsillectomy has weaknesses in that it associated with overweight later in adulthood. This puts children developing obstructive sleep apnea when they are older.
Awareness among member of the society should be created. Every child who snores more regularly should be subjected to screening. When Obstructive Sleep Apnea tested positive, evaluation and proper treatment should take place.
There are various suggestions for the analysis and controlling of OSA. All kids should be screened, complex and high-risk patients should be referred, and appropriate evaluation through historical and bodily examination. High-risk patients in the society should be examined carefully in hospitals. Additionally, more specialists should be trained so as to cater for the large numbers of children suffering from obstructive sleep apnea.
The methodologies used to treat obstructive sleep apnea have weakness in that, it’s time-consuming, and a lot of finances are needed during treatment. To solve this problem, a less sophisticated methodology can be used. For example, continuous airway pressure is useful to patients suffering from Obstructive Sleep Apnea treatment is effective since no surgery is required and follow up visits can be done once in every six months. The procedure is time-consuming and also cost effective.
Specific questions have been raised, and this gives room for more and additional research. These are areas include accurate prevalence data, documentation of risk factors for complications that are as a result of OSA research on cheaper screening methods. Most important, a further proper research should be done and recommend cheaper and a faster treatment method of OSA. A less cost effective method is important because it will encourage more patients to seek medical attention.
REFERENCES
Farber, J. M., Schechter, M. S., & Marcus, C. L. (2002). Clinical Practice Guideline: Diagnosis and Managing of Childhood Obstructive Sleep Apnea Syndromes. Pediatrics, 110(6), 1255-1257. doi:10.1542/peds.110.6.1255-a
Loghmanee, D. A., & Sheldon, S. H. (2010). Pediatric Obstructive Sleep Apnea: An Update. Pediatric Annals, 39(12), 784-789. doi:10.3928/00904481-20101116-09.