Sleep disorders in children

• Sleep disorders are very common in childhood and are often amenable to simple advice and parental education. • Questions about sleep should be an integral part of every paediatric consultation. • Children with underlying syndromes or complex medical conditions often have multiple sleep issues. • Excessive sleepiness in children requires careful historytaking and consideration of specialised investigation. • Obstructive sleep apnoea (OSA) is a common condition in childhood with important health implications. • The high prevalence of OSA warrants rigorous attempts to identify children at higher risk and manage them appropriately. • Adenotonsillectomy is a highly efficacious therapy for paediatric OSA. • A current major issue is to improve ways of distinguishing mild from severe OSA before a child undergoes adenotonsillectomy, as those with more severe disease are at increased risk of postoperative complications and should undergo adenotonsillectomy in a tertiary centre. • Children with obesity and other comorbid conditions are at increased risk of persisting OSA despite adenotonsillectomy. • Topical (nasal) steroids and/or anti-inflammatory agents have a role in the non-surgical treatment of mild OSA. • Continuous positive airway pressure and orthodontic interventions are treatment options for treatment of persisting OSA in children.