ABSTRACT
Polysomnography is the “gold standard” for diagnosis of sleep disordered breathing. An accurate history and physical exam can identify patients at risk for sleep disorders and possible complications of surgery. Primary snoring and obstructive sleep apnea (OSA) represent a spectrum of disorders indicating increased upper airway resistance to airflow. It should be noted that a small percentage of patients with OSA may have physiologic changes, such as cardiomegaly and pulmonary hypertension, due to the transient but repeated hypoxia that occurs during sleep and that accompanies the disease. A history of difficulty with swallowing due to enlarged tonsils, pharyngeal speech, or nasal obstruction should lead to questions about sleep and the possibility of apnea. There seem to be increased rates of OSA in African American children, and Asian children may also be predisposed to OSA. Although Mallampati scores are not currently well correlated with OSA in children, they are a general index for anatomic crowding associated with difficult intubation.
