Sleepless nights: obstructive sleep apnea in the pediatric patient.

Obstructive sleep apnea syndrome (OSAS) is a subtle but severe sleep disorder of early childhood. It occurs in 1.6%-3.4% of children between 6 months and 6 years of age. OSAS is often difficult to detect, and may have long-term consequences, including failure to thrive, behavioral disturbances, developmental delay, and cor pulmonale. Pediatric nurses are pivotal in assessing the clinical symptoms of OSAS so that prompt evaluation and treatment can be initiated. Early symptoms of OSAS include awakening with a startle or gasp, restlessness, retractions, inspiratory stridor, mouth breathing, and excessive sweating. Treatments vary, and include adenotonsilectomy, nasal continuous positive airway pressure (NCPAP), behavior modification, and tracheostomy.