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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El s&#237;ndrome de apnea obstructiva del sue&#241;o &#40;SAOS&#41; en los ni&#241;os es una enfermedad respiratoria frecuente y potencialmente grave&#44; dispone de un diagn&#243;stico fiable y de un tratamiento muy efectivo&#46; El SAOS es un trastorno respiratorio relacionado con el sue&#241;o&#44; forma parte del s&#237;ndrome de apneas-hipoapneas del sue&#241;o&#46; Afecta al 1-3&#37; de los ni&#241;os y&#44; adem&#225;s de las complicaciones cardiopulmonares&#44; puede producir retraso en el crecimiento&#44; dificultades de aprendizaje y se ha asociado con el cuadro de d&#233;ficit de atenci&#243;n con hiperactividad&#46; A partir de la sospecha cl&#237;nica&#44; la polisomnograf&#237;a es en la actualidad la &#250;nica prueba que permite diagnosticar y cuantificar la gravedad del SAOS en ni&#241;os&#46; La adenoamigdalectom&#237;a es el tratamiento de elecci&#243;n en la mayor&#237;a de los casos&#44; con una efectividad que supera el 85 &#37;&#46; El presente art&#237;culo es una revisi&#243;n actualizada de la evidencia acumulada sobre la cl&#237;nica&#44; la etiolog&#237;a&#44; el diagn&#243;stico&#44; las complicaciones y el tratamiento del SAOS en ni&#241;os&#46; El objetivo principal de este art&#237;culo es alertar a los pediatras sobre su papel esencial en la detecci&#243;n precoz de este s&#237;ndrome&#44; sobre todo a partir de los ni&#241;os que roncan&#44; as&#237; como orientar sobre el protocolo que debe seguirse para llegar al diagn&#243;stico y al tratamiento definitivos&#46;</p>"
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                        "tituloSerie" => "Am J Respir Crit Care Med"
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                        "paginaFinal" => "878"
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                          "autores" => array:1 [
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                        "tituloSerie" => "Sleep"
                        "fecha" => "1996"
                        "volumen" => "19"
                        "numero" => "10 Suppl"
                        "paginaInicial" => "S274"
                        "paginaFinal" => "S277"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9085530"
                            "web" => "Medline"
                          ]
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              "identificador" => "bib0055"
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                      "titulo" => "Arousal pattern following central and obstructive breathing abnormalities in infants and children"
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                          "autores" => array:3 [
                            0 => "F&#46; McNamara"
                            1 => "F&#46;G&#46; Issa"
                            2 => "C&#46;E&#46; Sullivan"
                          ]
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1996"
                        "volumen" => "81"
                        "paginaInicial" => "2651"
                        "paginaFinal" => "2657"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9018518"
                            "web" => "Medline"
                          ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Obstructive sleep apnea syndrome&#58; Differences between children and adults"
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                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;L&#46; Marcus"
                          ]
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                  "host" => array:1 [
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                      "Revista" => array:7 [
                        "tituloSerie" => "Sleep"
                        "fecha" => "2000"
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                        "numero" => "Suppl 4"
                        "paginaInicial" => "S140"
                        "paginaFinal" => "S141"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10893088"
                            "web" => "Medline"
                          ]
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            12 => array:3 [
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                      "titulo" => "Snoring&#44; apneic episodes&#44; and nocturnal hipoxemia among children 6 months to 6 years old&#46; An epidemiological study of lower limit of prevalence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46; Gislason"
                            1 => "B&#46; Benediktsdottir"
                          ]
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                    ]
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                  "host" => array:1 [
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                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
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                        "volumen" => "107"
                        "paginaInicial" => "9636"
                        "paginaFinal" => "9696"
                      ]
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                ]
              ]
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            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14&#46;"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Sleep-related breathing disorder in adolescents aged 12 to 16 years&#46; Clinical and polygrafic findings"
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                          "etal" => true
                          "autores" => array:6 [
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                            1 => "M&#46;A&#46; Fuentes-Pradera"
                            2 => "F&#46; Capote-Gil"
                            3 => "E&#46; Garcia-Diaz"
                            4 => "S&#46; Cano-Gomez"
                            5 => "C&#46; Carmona-Bernal"
                          ]
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                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2001"
                        "volumen" => "119"
                        "paginaInicial" => "1393"
                        "paginaFinal" => "1400"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11348944"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            14 => array:3 [
              "identificador" => "bib0075"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Natural history of primary snoring in children"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;L&#46; Marcus"
                            1 => "A&#46; Hamer"
                            2 => "G&#46;M&#46; Loughlin"
                          ]
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Pulmonol"
                        "fecha" => "1998"
                        "volumen" => "26"
                        "paginaInicial" => "6"
                        "paginaFinal" => "11"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9710274"
                            "web" => "Medline"
                          ]
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                ]
              ]
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            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathophysiology of childhood obstructive sleep apnea&#58; current concepts"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;L&#46; Marcus"
                          ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Physiol"
                        "fecha" => "2000"
                        "volumen" => "119"
                        "paginaInicial" => "143"
                        "paginaFinal" => "154"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10722857"
                            "web" => "Medline"
                          ]
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            16 => array:3 [
              "identificador" => "bib0085"
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                0 => array:1 [
                  "referenciaCompleta" => "Estivill E&#44; Esteller E&#46; El paciente roncador&#46; Formaci&#243;n m&#233;dica Continuada en Atenci&#243;n Primaria 8&#59;7&#58;439-46&#46;"
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            17 => array:3 [
              "identificador" => "bib0090"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obstructive sleep apnea and related disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;D&#46; Chervin"
                            1 => "C&#46; Guilleminault"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurol Clin"
                        "fecha" => "1996"
                        "volumen" => "14"
                        "paginaInicial" => "583"
                        "paginaFinal" => "609"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8871978"
                            "web" => "Medline"
                          ]
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                    0 => array:2 [
                      "titulo" => "Prevalence of snoring&#44; sleep disturbance and sleep related breathing disorders and their relation to daytime sleepiness in 4-5 years old children"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46;J&#46; Ali"
                            1 => "D&#46; Pitson"
                            2 => "J&#46;R&#46; Stradling"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1991"
                        "volumen" => "143"
                        "paginaInicial" => "A381"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inability of Clinical history to distinguish primary snoring from obstructive sleep apnea syndrome in children"
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                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;L&#46; Carroll"
                            1 => "S&#46;A&#46; McColley"
                            2 => "C&#46;L&#46; Marcus"
                            3 => "S&#46; Curtis"
                            4 => "G&#46;M&#46; Loughlin"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
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                        "paginaFinal" => "618"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7656605"
                            "web" => "Medline"
                          ]
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                ]
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            20 => array:3 [
              "identificador" => "bib0105"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Obstructive sleep apnea syndrome in infants and children&#58; Diagnosis and management"
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                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;L&#46; Carroll"
                            1 => "M&#46;G&#46; Loughlin"
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                        "titulo" => "Principles and practice of sleep medicine in the child"
                        "paginaInicial" => "163"
                        "paginaFinal" => "191"
                        "serieFecha" => "1995"
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                ]
              ]
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            21 => array:3 [
              "identificador" => "bib0110"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Ventricular dysfunction in children with obstructive sleep apnea&#58; Radionuclide assessment"
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                          "etal" => false
                          "autores" => array:4 [
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                            1 => "A&#46; Leiberman"
                            2 => "G&#46; Margulis"
                            3 => "S&#46; Sofer"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Pulmonol"
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                        "volumen" => "4"
                        "paginaInicial" => "139"
                        "paginaFinal" => "143"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2836784"
                            "web" => "Medline"
                          ]
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                ]
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            22 => array:3 [
              "identificador" => "bib0115"
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                    0 => array:2 [
                      "titulo" => "Blood pressure in children with obstructive sleep apnea"
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                          "autores" => array:3 [
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                        "tituloSerie" => "Am J Resp Crit Care Med"
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                        "paginaFinal" => "1103"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9563725"
                            "web" => "Medline"
                          ]
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                    0 => array:2 [
                      "titulo" => "Sleep apnea associated hypertension and reversible left ventricular hypertrophy"
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                            4 => "E&#46;T&#46; Ballard"
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                    ]
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                        "paginaInicial" => "253"
                        "paginaFinal" => "255"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2956404"
                            "web" => "Medline"
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              "identificador" => "bib0125"
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                      "titulo" => "Snoring in Portuguese primary school children"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11061801"
                            "web" => "Medline"
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                    0 => array:2 [
                      "titulo" => "Determinants of growth in children with the obstructive sleep apnea syndrome"
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                        "paginaInicial" => "556"
                        "paginaFinal" => "562"
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                          0 => array:2 [
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              "identificador" => "bib0140"
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                        "tituloSerie" => "Am J Respir Crit Care Med"
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                        "paginaFinal" => "1387"
                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
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                    0 => array:2 [
                      "titulo" => "A diagnostic approach to suspected obstructive sleep apnea in children"
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                        "paginaFinal" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6737123"
                            "web" => "Medline"
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Vol. 57. Núm. 6.
Páginas 540-546 (diciembre 2002)
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Vol. 57. Núm. 6.
Páginas 540-546 (diciembre 2002)
Acceso a texto completo
Síndrome de apnea obstructiva del sueño en el niño: una responsabilidad del pediatra
Obstructive sleep apnea syndrome in children: the responsibility of pediatricians
Visitas
16310
E. Verrilloa, R. Cilveti Portillob, E. Estivill Sanchob,
Autor para correspondencia
estivill@ctv.es

Correspondencia: Unitat d'Alteracions del Son. Institut Universitari Dexeus. P.° Bonanova, 61, 1.° 3.a. 08017 Barcelona. España
a Departamento de Scienze Neurologiche e Psichiatriche dell’ età infantile. Centro per i disturbi del Sonno in età Pediatrica. Università di Roma La Sapienza. Roma. Italia
b Unitat d'Alteracions del Son. Institut Universitari Dexeus. Barcelona. España
Este artículo ha recibido
Información del artículo

El síndrome de apnea obstructiva del sueño (SAOS) en los niños es una enfermedad respiratoria frecuente y potencialmente grave, dispone de un diagnóstico fiable y de un tratamiento muy efectivo. El SAOS es un trastorno respiratorio relacionado con el sueño, forma parte del síndrome de apneas-hipoapneas del sueño. Afecta al 1-3% de los niños y, además de las complicaciones cardiopulmonares, puede producir retraso en el crecimiento, dificultades de aprendizaje y se ha asociado con el cuadro de déficit de atención con hiperactividad. A partir de la sospecha clínica, la polisomnografía es en la actualidad la única prueba que permite diagnosticar y cuantificar la gravedad del SAOS en niños. La adenoamigdalectomía es el tratamiento de elección en la mayoría de los casos, con una efectividad que supera el 85 %. El presente artículo es una revisión actualizada de la evidencia acumulada sobre la clínica, la etiología, el diagnóstico, las complicaciones y el tratamiento del SAOS en niños. El objetivo principal de este artículo es alertar a los pediatras sobre su papel esencial en la detección precoz de este síndrome, sobre todo a partir de los niños que roncan, así como orientar sobre el protocolo que debe seguirse para llegar al diagnóstico y al tratamiento definitivos.

Palabras clave:
Síndrome de apnea obstructiva del sueño
Niños
Revisión
Amigdalectomía
Adenoidectomía
Polisomnografía
Ronquido
Alteraciones del sueño

Although obstructive sleep apnea syndrome (OSAS) in children is a frequent and potentially serious respiratory disorder, it has a reliable diagnosis and treatment is highly effective. OSAS is a respiratory sleep-related disorder that forms part of sleep apnea-hypoapnea syndrome. The syndrome affects between 1% and 3% of children. In addition to its cardiopulmonary complications, it can retard growth and increase the risk of hyperactivity and learning difficulties. It has also been associated with attention deficit disorder and hyperactivity. When OSAS is suspected, up-to-date nocturnal polysomnography is the gold standard for the diagnosis and quantification of severity of childhood OSAS. In most children the treatment of choice is adenotonsillectomy, which has a success rate of more than 85%. We provide an up-to-date review of the evidence on the clinical features, etiology, complications and treatment of OSAS in children. The main objective of this review is to alert pediatricians to their essential role in the early detection of this syndrome, especially among children who snore, and to provide a clinical practice guideline for the diagnosis and definitive treatment of these children.

Key words:
Obstructive Sleep Apnea Syndrome
Children
Review
Tonsillectomy
Adenoidectomy
Polysomnography
Snoring
Sleep Disorders
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Bibliografía
[1.]
M.S. Schechter.
and the Section of Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. Technical report: Diagnosis and management of childhood obstructive apnea syndrome.
Pediatrics, 109 (2002), pp. 4
[2.]
J. Durán, R. Rubio.
Síndrome de apneas-hipopneas durante el sueño en el niño.
An Esp Pediatr, 54 (2001), pp. 4-6
[3.]
J.R. Vila Asensi, J.M. De Miguel.
Síndrome de apnea obstructiva en la infancia.
An Esp Pediatr, 54 (2001), pp. 58-64
[4.]
E. Gonzalez Pérez-Yarza, A. Sánchez-Armengol, J. Durán, M.L. Alonso, J. De Miguel, J.A. Municio.
SAHS en niños y adolescentes. Clínica, diagnóstico y tratamiento.
Arch Bronconeumol, 38 (2002), pp. 34-39
[5.]
American Academy of Pediatrics.
Clinical practice guideline: Diagnosis and management of childhood obstructive sleep apnea syndrome.
Pediatrics, 109 (2002), pp. 704-712
[6.]
American Thoracic Society.
Standards and indications for cardiopulmonary sleep study in children.
Am J Respir Crit Care Med, 153 (1996), pp. 866-878
[7.]
O. Bruni.
Principi di medicina del sonno nel bambino.
Mediserve,, (2000),
[8.]
R.T. Bruillette, S.K. Fernbach, C.E. Hunt.
Obstructive sleep apnea in infants and children.
J Pediatr, 100 (1982), pp. 31-40
[9.]
ICDS-International classification of sleep disorder.
Diagnostic and coding manual. Diagnostic Classification Steering Committee.
[10.]
C.L. Rosen.
Obstructive sleep apnea syndrome (OSAS) in children: Diagnostic challenges.
Sleep, 19 (1996), pp. S274-S277
[11.]
F. McNamara, F.G. Issa, C.E. Sullivan.
Arousal pattern following central and obstructive breathing abnormalities in infants and children.
J Appl Physiol, 81 (1996), pp. 2651-2657
[12.]
C.L. Marcus.
Obstructive sleep apnea syndrome: Differences between children and adults.
Sleep, 23 (2000), pp. S140-S141
[13.]
T. Gislason, B. Benediktsdottir.
Snoring, apneic episodes, and nocturnal hipoxemia among children 6 months to 6 years old. An epidemiological study of lower limit of prevalence.
Chest, 107 (1995), pp. 9636-9696
[14.]
A. Sanchez-Armengol, M.A. Fuentes-Pradera, F. Capote-Gil, E. Garcia-Diaz, S. Cano-Gomez, C. Carmona-Bernal, et al.
Sleep-related breathing disorder in adolescents aged 12 to 16 years. Clinical and polygrafic findings.
Chest, 119 (2001), pp. 1393-1400
[15.]
C.L. Marcus, A. Hamer, G.M. Loughlin.
Natural history of primary snoring in children.
Pediatr Pulmonol, 26 (1998), pp. 6-11
[16.]
C.L. Marcus.
Pathophysiology of childhood obstructive sleep apnea: current concepts.
Respir Physiol, 119 (2000), pp. 143-154
[17.]
Estivill E, Esteller E. El paciente roncador. Formación médica Continuada en Atención Primaria 8;7:439-46.
[18.]
R.D. Chervin, C. Guilleminault.
Obstructive sleep apnea and related disorders.
Neurol Clin, 14 (1996), pp. 583-609
[19.]
N.J. Ali, D. Pitson, J.R. Stradling.
Prevalence of snoring, sleep disturbance and sleep related breathing disorders and their relation to daytime sleepiness in 4-5 years old children.
Am Rev Respir Dis, 143 (1991), pp. A381
[20.]
J.L. Carroll, S.A. McColley, C.L. Marcus, S. Curtis, G.M. Loughlin.
Inability of Clinical history to distinguish primary snoring from obstructive sleep apnea syndrome in children.
Chest, 108 (1995), pp. 610-618
[21.]
J.L. Carroll, M.G. Loughlin.
Obstructive sleep apnea syndrome in infants and children: Diagnosis and management.
Principles and practice of sleep medicine in the child, pp. 163-191
[22.]
A. Tal, A. Leiberman, G. Margulis, S. Sofer.
Ventricular dysfunction in children with obstructive sleep apnea: Radionuclide assessment.
Pediatr Pulmonol, 4 (1988), pp. 139-143
[23.]
C.L. Marcus, M.G. Greene, J.L. Carroll.
Blood pressure in children with obstructive sleep apnea.
Am J Resp Crit Care Med, 157 (1998), pp. 1098-1103
[24.]
R.D. Ross, S.R. Daniels, J.M. Loggie, R.A. Meyer, E.T. Ballard.
Sleep apnea associated hypertension and reversible left ventricular hypertrophy.
J Pediatr, 111 (1987), pp. 253-255
[25.]
A.M. Ferreira, V. Clemente, D. Gozal, A. Gomes, C. Pisarra, H. Cesar, et al.
Snoring in Portuguese primary school children.
Pediatrics, 106 (2000), pp. E64
[26.]
C.L. Marcus, J.L. Carroll, C.B. Koerner, A. Hamer, J. Lutz, G.M. Loughlin.
Determinants of growth in children with the obstructive sleep apnea syndrome.
J Pediatr, 125 (1994), pp. 556-562
[27.]
P. Nieminen, T. Löppönen, U. Tolonen, P. Lanning, M. Knip, H. Löppönen.
Growth and biochemical markers of growth in children with snoring and obstructive sleep apnea.
Pediatrics, 109 (2002), pp. 4
[28.]
American Thoracic Society.
Cardiorespiratory sleep studies in children. Establishment of normative data and polysomnographic predictors of morbidity.
Am J Respir Crit Care Med, 160 (1999), pp. 1381-1387
[29.]
R.T. Brouillette, D. Hanson, R. David, L. Klemka, A. Szatkowski, S. Fernbach, et al.
A diagnostic approach to suspected obstructive sleep apnea in children.
J Pediatr, 105 (1984), pp. 10-14
[30.]
M. Zucconi, L.F. Strambi, G. Pestalozza, E. Tessitore, S. Smirne.
Habitual snoring and obstructive sleep apnea syndrome in children: Effects of early tonsil surgery.
Int J Pediatr Otorhinolaryngol, 26 (1993), pp. 235-243
[31.]
E. Esteller, E. Estivill.
El ronquido y el Síndrome de Apnea Obstructiva en los niños.
Vigilia-Sueño, 12 (2000), pp. 29-35
Copyright © 2002. Asociación Española de Pediatría
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