{ "schema_version": 1, "kind": "condition", "id": "paediatric-obstructive-sleep-apnoea-referral", "name": "Paediatric Obstructive Sleep Apnoea Referral", "category": "chronic", "sources": "AAP Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome 2012 · Pediatric Obstructive Sleep Apnea - StatPearls - NCBI Bookshelf - disease-level clinical article (paediatric-obstructive-sleep-apnoea-referral-full.txt)", "review_status": "reviewed", "verified_against": "AAP Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome 2012 · No dose - referral pathway, no medicine given in primary care · Pediatric Obstructive Sleep Apnea - StatPearls - NCBI Bookshelf - disease-level clinical article (paediatric-obstructive-sleep-apnoea-referral-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1302, "generic": "Mometasone furoate", "line": 1, "is_adjunct": false, "form": "nasal", "strength_mg": 0.05, "adult_dose": "Not applicable - pediatric condition", "adult_duration": "6-12 weeks trial", "dose_source": "AAP Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome 2012", "rationale": "Intranasal corticosteroid trial reduces adenoid tissue size and mild OSA severity in children pending ENT referral", "cautions": [ "SPECIALIST ENT REFERRAL MANDATORY: Definitive treatment for pediatric OSA with adenotonsillar hypertrophy is adenotonsillectomy.", "Intranasal steroids are suitable for mild OSA or while awaiting surgical evaluation.", "Direct spray away from nasal septum to avoid epistaxis." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children >=2 years: 50 mcg (1 spray) into each nostril once daily in the morning for 6-12 weeks", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "2 years and over", "age_min_months": 24, "age_max_months": 216, "dose_text": "50 mcg (1 spray) into each nostril once daily in the morning for 6-12 weeks" } ], "peds_doses": null, "brands": [ { "trade_name": "SNIFFACAN 50MCG/G NASAL SPRAY 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA TEC", "price_egp": 25.2, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TABUNEX 50MCG/G NASAL SPRAY 120 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > AL ANSAR FOR MARKETING", "price_egp": 28.8, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NORHINOSE 50MCG/DOSE NASAL SPRAY 120 DOSES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND. > AMRIYA", "price_egp": 90.0, "pack_count": null, "unit_price": null, "strength_mg": 0.05, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "paediatric-obstructive-sleep-apnoea-referral" }, { "id": 1303, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "No dose - referral pathway, no medicine given in primary care", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - AHI greater than 9 events per hour (or mild-to-moderate disease with significant symptoms) is the threshold that warrants referral for adenotonsillectomy rather than continued medical trial.", "RED FLAG - Complex comorbidities (obesity, Down syndrome, craniofacial abnormalities, neuromuscular disorders) may require positive airway pressure therapy or, in severe cases, tracheotomy - a different pathway from a nasal-steroid trial.", "Oral or systemic steroids have no role in paediatric obstructive sleep apnoea; only the intranasal route has evidence of benefit.", "Montelukast carries a risk of serious neuropsychiatric adverse effects including suicidal ideation, depression, anxiety, agitation and hallucinations.", "Examine the cardiovascular system for signs of pulmonary hypertension, and assess muscle tone, in any child being worked up for obstructive sleep apnoea.", "The increased work of breathing can cause failure to thrive, particularly in younger children.", "Children born prematurely may not show the classic features, so refer for a sleep study at a low threshold.", "Assess sleep quality and duration in every child being evaluated for ADHD before any medication is started.", "Secondary nocturnal enuresis in a child is itself a reason to evaluate for obstructive sleep apnoea.", "Children with Down syndrome or craniofacial abnormalities need post-operative surveillance and a repeat sleep study at least yearly, because the apnoea often persists or recurs after surgery." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "paediatric-obstructive-sleep-apnoea-referral" } ] }