The Role of Polysomnography in Diagnosing and Treating Obstructive Sleep Apnea in Pediatric Patients

Obstructive sleep apnea in children is associated with serious neurocognitive and cardiovascular morbidity, systemic inflammation, and increased health care use, yet remains underdiagnosed. Although the prevalence of obstructive sleep apnea is 1-3% in the pediatric population, the prevalence of primary snoring (PS) is estimated to be 3-12%. The challenge for pediatricians is to differentiate PS from obstructive sleep apnea in a cost-effective, reliable, and accurate manner before recommending invasive or intrusive therapies, such as surgery or continuous positive airway pressure. The validity of polysomnography as the gold standard for diagnosing obstructive sleep apnea has been challenged, primarily related to concerns that abnormalities on polysomnography do not correlate well with advers outcomes, that those abnormalities have statistical mor than clinical significance, and that performing polysomne grams on all children who snore is a practical impossibility The aim of this article is to review the clinical utility c diagnostic tests other than polysomnography to diagnos obstructive sleep apnea, to highlight the limitations an strengths of polysomnography, to underscore the threshol levels of abnormalities detected on polysomnography thc correlate with morbidity, and to discuss what the practice implications are for treatment. Curr Probl Pediatr Adolesc Health Care 2012;42:2-25