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Management of obstructive sleep apnea syndrome type 1 in children and adolescents – A French consensus - 24/09/23

Doi : 10.1016/j.arcped.2023.06.009 
G. Aubertin a, b, c, , M. Akkari d, A. Andrieux e, f, g, C. Colas des Francs h, i, B. Fauroux j, k, P. Franco h, l, F. Gagnadoux m, n, O. Gallet de Santerre o, B. Grollemund p, S. Hartley i, q, D. Jaffuel r, s, L. Lafond t, C.M. Schröder u, v, w, C. Schweitzer x, y, C. Charley-Monaca z
a Pediatric Pulmonology, Armand Trousseau Hospital, AP-HP Hospital, Sorbonne University, Paris, 75012, France 
b Centre de recherche Saint Antoine (CRSA), INSERM UMR-S 938, Paris, 75012, France 
c Centre de pneumologie de l'enfant, Ramsay Générale de Santé, Boulogne-Billancourt, 92100, France 
d Ear, Nose and Throat & Head and Neck Surgery, University Hospital Gui de Chauliac, University of Montpellier, Montpellier, 34000, France 
e Cabinet de pneumo-pédiatrie et somnologie pédiatrique, Mérignac, 33700, France 
f Pôle d'Exploration des Apnées du Sommeil (PEAS), Nouvelle Clinique Bel Air, Bordeaux, 33200, France 
g Pediatric Pulmonology Unit, University Hospital Pellegrin – Enfants, University of Bordeaux, Bordeaux, 33000, France 
h Pediatric Sleep Unit, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, 69500, France 
i Réseau Morphée, Garches, 92380, France 
j Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, Paris, 75015, France 
k VIFASOM, University of Paris Cité, Paris, 75004, France 
l Integrative Physiology of the Brain Arousal Systems, CRNL, INSERM U1028, CNRS UMR5292 University of Lyon 1, Bron, 69675, France 
m Department of Pulmonary and Sleep Medicine, University Hospital of Angers, Angers, 49000, France 
n INSERM 1083, UMR CNRS 6015, MITOVASC, Equipe CarME, SFR ICAT, University of Angers, Angers, 49000, France 
o ENT surgeon, Montpellier, 33000, France 
p Department of Dental-Facial Orthopedics, Pole of Bucco Dentaries' Medicine and Surgery, Cleft Competence Center, Strasbourg University Hospital, Strasbourg, 67000, France 
q Sleep Unit, Department of Physiology, Raymond Poincaré Hospital, AP-HP, Garches, 92380, France 
r Department of Respiratory Diseases, University Hospital of Montpellier, Montpellier, 34000, France 
s PhyMedExp, CNRS, INSERM, Montpellier University, Montpellier, 34000, France 
t Oro-myofunctional Therapy Office, Bordeaux, 33000, France 
u Department of Child and Adolescent Psychiatry, Strasbourg University and Strasbourg University Hospitals, Strasbourg, 67000, France 
v CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, 67000, France 
w Sleep Disorders Center & CIRCSom (International Research Center for ChronoSomnology), Strasbourg University Hospitals, Strasbourg, 67000, France 
x Children's Medicine, Department of Pediatric Lung Function Testing, Children's Hospital, University Hospital of Nancy, Vandoeuvre les Nancy, 54501, France 
y EA3450 Développement Adaptation et Handicap (DevAH), University of Lorraine, Vandoeuvre les Nancy, 54505, France 
z Department of Clinical Neurophysiology-Sleep Disorders Unit, University of Lille, University Hospital of Lille, and U1172 – LilNCog – Lille Neurosciences & Cognition, Lille, 59000, France 

Corresponding author at: Department of Pediatric Pulmonology, Hôpital Armand Trousseau, 26 avenue du Dr Arnold Netter, 75012, Paris, France.Department of Pediatric PulmonologyHôpital Armand Trousseau26 avenue du Dr Arnold NetterParis75012France

Abstract

This document is the outcome of a group of experts brought together at the request of the French Society of Sleep Research and Medicine to provide recommendations for the management of obstructive sleep apnea syndrome type 1 (OSA1) in children.

The recommendations are based on shared experience and published literature. OSA1 is suspected when several nighttime respiratory symptoms related to upper airway obstruction are identified on clinical history taking. A specialist otolaryngologist examination, including nasofibroscopy, is essential during diagnosis. A sleep study for OSA1 is not mandatory when at least two nighttime symptoms (including snoring) are noted. Therapeutic management must be individualized according to the location of the obstruction. Ear, nose, and throat (ENT) surgery is often required, as hypertrophy of the lymphoid tissues is the main cause of OSA1 in children. According to clinical findings, orthodontic treatment generally associated with specialized orofacial–myofunctional therapy might also be indicated. Whatever treatment is chosen, follow-up must be continuous and multidisciplinary, in a network of trained specialists.

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Keywords : Apnea, Obstructive sleep-disordered breathing, Children, Pediatrics, Consensus


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Vol 30 - N° 7

P. 510-516 - octobre 2023 Regresar al número
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