Binal Kancherla, MD, from Baylor College of Medicine

Binal Kancherla, MD

Adolescent OSA Management Needs Guideline Update, Says Binal Kancherla, MD 

Binal Kancherla, MD, from Baylor College of Medicine, presented on the diagnostic and treatment dilemmas when managing 

SLEEP 2025, the 39th annual meeting of the Associated Professional Sleep Societies

 sat down with Kancherla during the meeting to discuss the 

primary diagnostic challenges when evaluating OSA in adolescents, whether to use pediatric or adult AHI thresholds

, and whether updated clinical guidelines specific to adolescent OSA are needed. In the first half of the interview, Kancherla said she recommends managing adolescent OSA with pediatric criteria since they are continuing to grow and develop. Still, it can be tricky to manage OSA in teens, especially when patients at this age start wanting autonomy over their treatments.

“I believe that the age group from age 15 to 17 can be the trickiest time,” Kancherla told HCPLive when asked about the need for updated guidelines. “I think there's a discrepancy in a lot of sleep centers across the country and how they're treating that age group, and maybe we need to identify factors that are unique to that age group in treating their OSA.”

As of now, there are no discovered biomarkers to identify OSA in adolescents. Kancherla emphasized the importance of a multidisciplinary approach in treating OSA in this age group, beginning with proper screening and assessment of OSA severity. From there, clinicians should develop a personalized treatment plan tailored to the individual's needs.

Kancherla said untreated OSA during adolescence can result in severe mental health and developmental outcomes. Although there is not a lot of longitudinal data, she pointed out that development impacts school and athletic performance. OSA can also increase the risk of high blood pressure.

“I think there's a combination of problems that we see in this age,” Kancherla said. “Again, we don't know what is going to happen and when it's going to happen. It could be 5 years down the road. It could be 10 years down the road. We just know that the risk is higher. So, it's important to identify OSA and treat it as best we can.”

Majid R, Kancherla B, and Wani A. Adult or Pediatric? Diagnostic and Treatment Dilemmas when Managing Teen OSA. Presented at SLEEP 2025, the 39th annual meeting of the Associated Professional Sleep Societies, on Monday, June 9th, in Seattle, Washington.

Videos

At SLEEP 2025, Kancherla highlights diagnostic dilemmas, treatment gaps, and the need for pediatric criteria when managing obstructive sleep apnea in teens.


Adolescent OSA Management Needs Guideline Update, Says Binal Kancherla, MD

Why Teens with OSA Shouldn’t Be Treated Like Adults, with Binal Kancherla, MD

, on Monday, June 9th, in Seattle, Binal Kancherla, MD, from Baylor College of Medicine, talked about the trickiness of treating 

 in adolescents. Should you use pediatric or adult criteria?

“I think adolescence is a difficult time in life where there is that transition into adulthood, and a lot of their diagnoses and treatment can look like what adults are doing, but it's not necessarily exactly the same,” Kancherla told 

Many teenagers want autonomy over their treatments. Since they are still minors, Kancherla said it is important to use a family approach, letting the teen be involved in their treatment plan. Kancherla believes adolescent OSA should be managed with pediatric care.

“Considering teenagers as small adults is not the right thing to do,” she added. “Using pediatric criteria is important because we know that adolescents can continue to grow and develop up to age 18. So many centers, up to at least a minimum of 17 years of age, will use pediatric criteria when treating children. If you're using adult criteria under 17 years, you run the risk of missing certain things in the diagnosis.”

Children have fewer OSA requirements for starting treatment than the adult population. Yet, despite fewer requirements, even just a little bit of sleep apnea in children can lead to long-term growth and development consequences. The same can apply to adolescents.

When it comes to adolescents, developmental and anatomical factors, such as puberty-related changes in airway size, body mass index (BMI), and sleep architecture, can complicate the interpretation of sleep study results. During puberty, children do not just undergo linear growth but also weight gain, and obesity is known as a risk factor for sleep apnea.

Teenagers also experience airway anatomical changes, with the airway developing up to age 13 or 14 years in females and age 16 years in males.

“The important thing to remember is that there can be a high degree of variability in the diagnosis of OSA in these ages, and therefore it's important to do frequent follow-up,” Kancherla said.

At SLEEP 2025, Kancherla emphasized the importance of using pediatric criteria to manage OSA in adolescents, warning that adult standards may overlook key developmental factors.


Binal Kancherla, MD

Articles