Bilevel PAP Transforms a Teen’s Life

This chapter examines the interplay between obesity and the selection of treatment for severe sleep obstructed breathing in children and adolescents. It reviews the physiology of obstructive sleep apnea and hypoventilation, as well as the importance of partial-pressure carbon dioxide monitoring in evaluating sleep disordered breathing in obese children. It discusses the effectiveness, adherence, and clinical outcomes of various treatment options for pediatric obstructive sleep apnea/hypoventilation, including adenotonsillectomy, positive airway pressure (PAP) therapy, and weight loss. It also reviews current literature on newer-generation, autotitrating PAP devices and their role in pediatric obstructive sleep apnea. Finally, it discusses the role of oxygen therapy in the management of pediatric obstructive sleep apnea.