Dyssomnias in children

Obstructive sleep apnea (OSA)

Close follow-up after starting the use of continuous positive airway pressure (CPAP) is recommended to identify problems complicating and preventing its use. Children prescribed CPAP, particularly younger children and infants, need to be reassessed frequently, as changes in body weight, muscle tone, airway size and compliance, and adenotonsillar size may either increase the pressure requirements or decrease them, possibly to the point of eliminating the need for CPAP. Likewise, a low threshold for re-evaluating children at risk for OSA (e.g., with low muscle tone, craniofacial abnormalities, chromosomal disorders) should be maintained if symptoms reemerge despite having a normal polysomnogram (PSG) in the past, or having been shown on previous PSG to have had resolution of symptoms after adenotonsillectomy.