This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Richards, W. Articles by Ferdman, R. M. Search for Related Content PubMed PubMed Citation Articles by Richards, W. Articles by Ferdman, R. M. Social Bookmarking                   What's this?

Prolonged Morbidity Due to Delays in the Diagnosis and Treatment of Obstructive Sleep Apnea in Children

Ronald M. Ferdman, MD

Division of Clinical Immunology and Allergy, Childrens Hospital Los Angeles, Department of Pediatrics, University of Southern California, Los Angeles, CA

The inclusion of a query concerning the presence of snoring in a questionnaire used by the Allergy Service of Childrens Hospital Los Angeles (CHLA) uncovered a significant number of patients who were experiencing prolonged and discomforting symptoms owing to previously undiagnosed obstructive sleep apnea (OSA) caused by adenotonsillar hypertrophy. Of 352 patients who were discharged with a diagnosis of OSA and tonsillectomy and/or adenoidectomy at CHLA in 1996-1997, a retrospective study of the first 45 randomly selected patients who agreed to participate in a telephone interview was performed. Analysis revealed that all patients experienced severe and discomforting symptoms with all describing severe or moderate snoring. Other symptoms included chronic mouth breathing (84%), frequent otitis media (64%), sinusitis (56%), sore throat (51%), choking (47%), and daytime drowsiness (42%). Other symptoms included poor school performnce, enuresis, poor appetite and/orxweight gain, dysphagia, and vomiting. Symptoms began at a mean age of approximately 2 years ("birth"-9 years), and the mean period of time between the development of significant symptoms and OSA was 3.3 years (6 months-1 3 years). Delay between onset of significant symptoms and surgery was>1 year in 82% of the patients,>2 years in 51% of the patients,>4 years in 31% of the patients, and>6 years in 13% of the patients. Forty percent of patients were self-referred to an otolaryngologist for treatment despite their primary care physician being aware of the symptoms. These results indicate that patient with OSA experienced prolonged morbidity and delays in treatment, which is probably widespread. Physican, parent, and third-party factors were found to have contributed to the delays in treatment.

Clinical Pediatrics, Vol. 39, No. 2, 103-108 (2000)
DOI: 10.1177/000992280003900205


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				K A Bonuck, K Freeman, and J Henderson Growth and growth biomarker changes after adenotonsillectomy: systematic review and meta-analysis Arch. Dis. Child., February 1, 2009; 94(2): 83 - 91. [Abstract] [Full Text] [PDF]

				V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) Circulation, September 2, 2008; 118(10): 1080 - 1111. [Full Text] [PDF]

				V. K. Somers, D. P. White, R. Amin, W. T. Abraham, F. Costa, A. Culebras, S. Daniels, J. S. Floras, C. E. Hunt, L. J. Olson, et al. Sleep Apnea and Cardiovascular Disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement From the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing In Collaboration With the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health) J. Am. Coll. Cardiol., August 19, 2008; 52(8): 686 - 717. [Full Text] [PDF]

				J. N. Roemmich, J. E. Barkley, L. D'Andrea, M. Nikova, A. D. Rogol, M. A. Carskadon, and P. M. Suratt Increases in Overweight After Adenotonsillectomy in Overweight Children With Obstructive Sleep-Disordered Breathing Are Associated With Decreases in Motor Activity and Hyperactivity Pediatrics, February 1, 2006; 117(2): e200 - e208. [Abstract] [Full Text] [PDF]