A large observational study comprising 568 children proved intranasal steroids to be beneficial in improving the symptoms of obstructive breathing during sleep in 56% of the children, as reported in the International Journal of Otorhinolaryngology.

Rowe Katherine Sylvia et al. sought to describe the influence of intranasal steroids (INS) or corticosteroid nasal sprays on symptom improvement and the need for surgery in pediatric sleep-disordered breathing (SDB). The obstructive sleep apnea (OSA)-5 questionnaire screening tool with clinical and surgical outcome measures was used to examine the effect of INS in 568 children under consideration.

At the initial visit, the mean OSA-5 score stood at 7.78, with symptoms persisting for a median duration of 9 months (range 2–72). Fifty-one per cent of participants underwent a trial of INS, with 56% reporting symptom improvement. Among those prescribed corticosteroid nasal sprays, the mean score dropped considerably from 8.2 to 5.5 (p < 0.0001) and had a higher symptom severity (p < 0.01), nasal turbinate size (p < 0.005), and record of atopy disease (p < 0.01) compared to the non-trial group.

Surgical intervention rates were notably lower in the INS group (38%) compared to the non-trial group (56%) (p < 0.001). Furthermore, as symptom severity increased, the reported improvement with INS and the reduction in surgery rates also increased. Baseline OSA-5 scores served as predictors for surgery rates, while atopic status and age did not influence the response to the corticosteroid nasal sprays.