Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome

To the Editor.—

I have major reservations in respect to the recent clinical practice guideline on obstructive sleep apnea syndrome (OSAS).¹  Although it is important to alert pediatricians to the existence of this condition, the ramifications of following the guideline do not appear to have been given adequate consideration.

The authors signed letters stating they did not have a conflict of interest. I assume this means they do not run polysomnography (PSG) labs, as an obvious consequence of the report will be a markedly increased demand for their use.

One problem concerns children with primary snoring (PS). This can be seen, according to the report, in up to 12% of preschool-aged children. Furthermore, there is apparently no way to rule out OSAS in these children, without doing PSG. The unmistakable conclusion, therefore, is that up to 12% of preschool-aged children should be undergoing PSG. Do other pediatricians find...