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Correspondence |

Repeated Polysomnograms After Antiinflammatory Therapy of Mild Pediatric OSAPolysomnography to Assess Posttherapy OSA Status FREE TO VIEW

Nadav Traeger, MD; Priya S. Prashad, MD
Author and Funding Information

From the Department of Pediatrics, New York Medical College.

CORRESPONDENCE TO: Nadav Traeger, MD, New York Medical College, Pediatrics, 40 Sunshine Cottage Dr – Skyline, Rm 1N-E29, Valhalla, NY 10595; e-mail: nadav_traeger@nymc.edu


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(6):e226. doi:10.1378/chest.14-1988
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To the Editor:

We read the recent article in CHEST (July 2014) by Kheirandish-Gozal et al1 with great interest. Over the past 2 decades, there have been several publications on the use of antiinflammatory medications for the treatment of mild OSA in children. Taken together, they provide increasingly compelling evidence that, at least for a select subset of patients, our medical field may need to undergo a paradigm shift from a surgical to a medical approach for the treatment of this relatively common condition.

The authors made a significant contribution to the available literature, as their article is the most robust to date in terms of both the breadth (ie, large number of subjects) and the depth (ie, performing serial polysomnograms). We agree with the authors’ conclusion that a multicenter randomized trial is needed to further corroborate these results, but, in the meantime, we are hoping that the authors would be able to shed some light on a specific aspect of this treatment approach that has not been adequately addressed in the literature. Several authorities in this medical field, such as Marcus,2 proposed that it may be necessary to routinely perform polysomnography on patients treated with antiinflammatory medications due to the inherent limitations of the clinical evaluation in correctly identifying patients with OSA. We respectfully ask the current authors if they could address this question given the data they collected for this article, namely, what was the reliability of the posttreatment symptoms in discriminating between persistence or resolution of OSA on the posttreatment polysomnograms?

References

Kheirandish-Gozal L, Bhattacharjee R, Bandla HPR, Gozal D. Antiinflammatory therapy outcomes for mild OSA in children. Chest. 2014;146(1):88-95. [CrossRef] [PubMed]
 
Marcus CL. Nasal steroids as treatment for obstructive sleep apnea: don’t throw away the scalpel yet. J Pediatr. 2001;138(6):795-797. [CrossRef] [PubMed]
 

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Tables

References

Kheirandish-Gozal L, Bhattacharjee R, Bandla HPR, Gozal D. Antiinflammatory therapy outcomes for mild OSA in children. Chest. 2014;146(1):88-95. [CrossRef] [PubMed]
 
Marcus CL. Nasal steroids as treatment for obstructive sleep apnea: don’t throw away the scalpel yet. J Pediatr. 2001;138(6):795-797. [CrossRef] [PubMed]
 
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