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. Author manuscript; available in PMC: 2021 Apr 1.
Published in final edited form as: Lung. 2020 Mar 12;198(2):257–270. doi: 10.1007/s00408-020-00342-5

TABLE 5:

Management of the Child with OSAS

Otherwise healthy children
Mild OSAS Moderate OSAS Severe OSAS

  • AT vs watchful waiting for 6 months

  • Intranasal corticosteroid

  • Weight management, if overweight/obese

  • Specialist referral (e.g. sleep medicine, otolaryngology)

  • AT

  • PAP therapy

  • Weight management, if overweight/obese

  • Specialist referral (e.g. sleep medicine, otolaryngology)

  • Cardiology evaluation

  • AT with overnight observation

  • PAP therapy

  • Weight management, if overweight/obese
Children with complex comorbidities
Mild OSAS Moderate OSAS Severe OSAS

  • Specialist referral (e.g. sleep medicine, otolaryngology)

  • AT

  • Intranasal corticosteroid

  • Weight management, if overweight/obese

  • Specialist referral (e.g. sleep medicine, otolaryngology)

  • AT with overnight observation

  • Other airway and/or craniofacial surgery

  • PAP therapy

  • Weight management, if overweight/obese

  • Specialist referral (e.g. sleep medicine, otolaryngology, craniofacial team)

  • Cardiology evaluation

  • AT with overnight observation

  • Other airway and/or craniofacial surgery

  • PAP therapy

  • Weight management, if overweight/obese
Children with residual OSAS following AT
Mild OSAS Moderate OSAS Severe OSAS

  • Intranasal corticosteroid

  • Weight management, if overweight/obese

  • PAP therapy

  • Weight management, if overweight/obese

  • PAP therapy

  • Weight management, if overweight/obese

  • Secondary surgical intervention

  • Tracheostomy

AT, adenotonsillectomy

OSAS, obstructive sleep apnea syndrome

PAP, positive airway pressure