New approaches to the diagnosis of sleep-disordered breathing in children

Sleep-disordered breathing in general and particularly, obstructive sleep apnea syndrome (OSAS) are highly prevalent conditions in children. Current diagnostic approaches range from exclusively using clinical presentation and physical examination to the current “Gold Standard” of overnight polysomnography (NPSG). But while it is clear that the former is fraught with major limitations, the latter is also associated with significant obstacles, such as relative unavailability of appropriately equipped sleep laboratories and trained personnel, the labor intensive nature of NPSG and its inconvenience, and, of course, the high cost of the procedure. These limitations are detrimental to timely diagnosis and treatment. Novel approaches to the evaluation of community-based and clinically referred pediatric populations are discussed and should stimulate the field in the search for improved diagnostic technologies and delineation of a more pragmatic and reliable diagnostic approach for pediatric SDB.