Background

Obstructive sleep apnea (OSA) and habitual snoring (HS) are highly prevalent conditions in children: around 10 % to 30 % for HS and 1 % to 4 % for OSA have been reported in cross-sectional studies.1-8 Both HS and OSA are associ-ated with a vast array of adverse health consequences, such as neurocognitive and behavioral impairments, decreased academic performance, and alterations in meta-bolic and cardiovascular function, which can ultimately promote deleterious outcomes even in adulthood.9-22 HS is defined per consensus as the presence of nocturnal snor-ing for 3 or more nights on average per week, and the diagnosis of OSA and its severity is based on the presence of specific respiratory and electroencephalographic altera-tions in the overnight polysomnogram.23-25 Furthermore, timely diagnosis and treatment of sleep-disordered breath-ing (SDB) is associated with marked improvements and reversibility of the disease-associated morbidities.26-29 To ensure that children with SDB receive appropriate atten-tion from health care providers, the American Academy of Pediatrics (AAP) issued a set of evidence-based recom-mendations in 2002, whereby screening for snoring should be a constitutive and essential component of all well-child visits. Specifically, whether a child snores or not should be documented, and if affirmative, appropriat