We are responding to the Clinical Challenges in Otolaryngology section in the March issue of the ARCHIVES regarding preoperative sleep studies in children.1- 3 It is true that sleep-related breathing disorders are frequently unrecognized in children, but we disagree with the message of this article and the accompanying editorial comments. Certainly, there are cases in which a diagnostic sleep study may not be necessary, but ideally this should be the rare exception. Our overall goal must be to improve the health of children. The core question is: how can the sleep study assist in that goal? The challenge we face in sleep medicine is providing easily accessible and cost-effective care while working within a multidisciplinary model. We do not recommend, nor is it the standard of care, that sleep apnea surgery be done in adults without a preliminary sleep study. Why have lower standards for children?
Pelayo R, Powell N, Guilleminault C. Evaluation of Obstructive Sleep Apnea by Polysomnography Prior to Pediatric Adenotonsillectomy. Arch Otolaryngol Head Neck Surg. 1999;125(11):1282-1283. doi:10.1001/archotol.125.11.1282