CHEST Guidelines-Repeated-Polysomnograms-After-Antiinflammatory-The

Repeated-Polysomnograms-After-Antiinflammatory-The

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The correspondence discusses the potential paradigm shift in the treatment of mild pediatric obstructive sleep apnea (OSA) from a surgical approach, such as adenotonsillectomy, to a medical one using anti-inflammatory medications. Dr. Nadav Traeger and Dr. Priya S. Prashad address their concerns to the authors of a study published in CHEST, led by Kheirandish-Gozal et al., which provided significant findings on the topic. They agree with the suggestion for a multicenter randomized trial to validate these findings and question whether post-treatment symptoms reliably indicate the resolution or persistence of OSA, suggesting the need for routine polysomnography.<br /><br />In response, Dr. David Gozal and Dr. Leila Kheirandish-Gozal acknowledge the importance of the question raised but indicate the limitations of their study due to its retrospective nature, preventing them from giving a scientifically valid answer. They note from previous research that clinical symptoms post-treatment are often unreliable indicators of residual OSA. Factors like obesity, older age, and severe pre-treatment OSA are identified as risks for residual OSA after treatment. They advocate for multicenter efforts to develop more comprehensive instruments that assess both symptoms and physical findings, to better diagnose and determine treatment effectiveness for OSA in children.<br /><br />The correspondence highlights ongoing debates and the need for further research to confirm whether non-surgical treatments for mild pediatric OSA can reliably replace surgical interventions and how best to monitor treatment effectiveness.

Keywords

pediatric obstructive sleep apnea

adenotonsillectomy

anti-inflammatory medications

multicenter randomized trial

polysomnography

residual OSA

treatment effectiveness

non-surgical treatments

clinical symptoms

Kheirandish-Gozal