Diagnosis can be made with a careful history review and parental observation. Definitive diagnosis is confirmed with a sleep study. Unfortunately, the time and effort required for a formal sleep study often exceeds that of the surgical alternative (removing the tonsils and adenoids). Even so, getting a sleep study is never a bad idea, especially in the very young or high-risk patient.
To contribute to an SDB diagnosis, parents may observe:
- Obstructions to breathing, gasping, snorting, and thrashing in bed
- Unexplained bedwetting
- Alteration in mood, misbehavior, and poor school performance
Note: Not every child who has these characteristics has SDB, but if a child is a serious snorer and is experiencing mood, behavior, and performance problems, SDB should be considered.
A child with suspected SDB should be evaluated by an otolaryngologist – head and neck surgeon.
Other pediatric sleep disorder diagnoses include Sudden infant death syndrome (SIDS) and apparent life threatening episode (ALTE). Children who have had an ALTE warrant thorough evaluation by a pediatric sleep specialist.
Children with craniofacial abnormalities, primarily abnormalities of the jaw bones, tongue, and associated structures, often have SDB. This must be managed and the deformities treated as the child grows.
The sleep test is the standard diagnostic test for SDB. This test can be performed in a sleep laboratory or at home. Sleep tests can produce inaccurate results, especially in children. Borderline or normal sleep test results may still result in a diagnosis of SDB based on parental observation and clinical evaluation.