“Anesthetic Risks of Obstructive Sleep Apnea in Children”
Signs and Symptoms of OSA in Children
- BMI at or above the 95th percentile for age and gender
- Craniofacial abnormalities
- Nasal obstruction
- “Kissing” tonsils
- Intermittent vocalization during sleep
- Parental report of restlessness, difficulty breathing, or struggling to breathe while sleeping
- Night terrors
- Child sleeps in unusual positions
- Child with new onset enuresis
- Parent or teacher comments of daytime sleepiness, distractibility, aggression, or irritability
- Child difficult to arouse at usual awakening time
Conclusions
- Children with moderate to severe OSA are at increased risk for adverse perioperative events
- OSA may not be diagnosed in children, and a high index of suspicion is needed
- Careful preoperative assessment, intraoperative management, and postoperative care can decrease this risk