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medpundit |
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Tuesday, April 02, 2002The American Academy of Pediatrics has issued a treatment guideline on childhood snoring that says “yes”, but the full report leaves one wondering why? The guidelines were the result of a panel of physicians sitting down and reviewing 2067 articles on snoring and sleep apnea in children. (Well, they didn’t all sit down and review them, some of them were handed over to residents and fellows to do the hard work of digesting them.) They then combined the different data together, when they could, to come up with conclusions about snoring. A lot of the data was so divergent, however, that they couldn’t combine them. They can’t even agree on the prevalence of snoring in children. It could be anywhere from 3% to 12%. Treatment of snoring didn’t seem to make much difference. Grades improved from an average of 2.43 to 2.87 (not enough to make the honor roll), treatment “did not result in any statistically significant improvement in development or temperament,” and in some studies it did not make any difference in height, although treated children did gain weight. Furthermore, they can’t agree on how to diagnose problem snoring in children: “One of the problems in evaluating various methods of diagnosing OSAS (obstructive sleep apnea syndrome) in children is that the gold standard, overnight PSG (polysomnogram, or sleep study), has not been well standardized in its performance or interpretation. Although recent consensus statements pertaining to standards and normative data should lessen this problem, the question of definition remains problematic.” (parenthetical statements are mine) It’s not clear why the AAP decided to publish the recommendations when they are based on such weak data. It’s almost as if the panel did all that hard work then hated to admit it wasn’t worth the effort posted by Sydney on 4/02/2002 05:40:00 AM 0 comments 0 Comments: |
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