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Letters to the Editor
November 1999

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

We are responding to the Clinical Challenges in Otolaryngology section in the March issue of the ARCHIVES regarding preoperative sleep studies in children.13 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?

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