[Pediatricians and sleep-disordered breathing in the child].

OBJECTIVES

Assessment of opinions and practices of pediatricians concerning sleep-disordered breathing (SDB) in children.

METHODS

Randomly 516 pediatricians were selected in the state of São Paulo, Brazil. A survey mailed to them included questions regarding: their professional profile, knowledge about SDB in childhood, opinions and practices for diagnosis and treatment of these diseases.

RESULTS

112 anonymous completed surveys were returned (21.7%). The teaching of SDB during medical school and pediatric residency raining was considered unsatisfactory respectively by 65.2% and 34.8% of the pediatricians. Forty-nine respondents (43.8%) rated their knowledge about SDB in children as regular, 39 (34.8%) as good and 17 (15.2%) as unsatisfactory. The most important sleep-related questions were: mouth breathing, breathing pauses, sleep amount, excessive daytime sleepiness and nocturnal wheezing. Clinical aspects regarded as the most significant for suspecting obstructive sleep apnea syndrome (OSAS) were: breathing pauses, adenoid hypertrophy, mouth breathing, craniofacial anomaly and snoring. The most frequent practices for evaluation of OSAS in children were: cavum radiography with referral to an otorhinolaryngologist (25%) and nocturnal pulse oximetry (14.2%). Only 11.6% of pediatricians recommended overnight polysomnography and 4.5%, nap polysomnography. The most effective practices for SDB were considered to be: adenoidectomy and adenotonsillectomy, parents counseling, weight loss and sleep hygiene.

CONCLUSIONS

There is a gap between research on SDB in childhood and pediatric practice.