What causes childhood obstructive sleep apnea (OSA)?

Updated: Feb 13, 2019
  • Author: Mary E Cataletto, MD; Chief Editor: Denise Serebrisky, MD  more...
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Obesity and hypertrophy of tonsils and/or adenoids account for most cases of obstructive sleep apnea in children. [1] However, any anomaly of the upper airway may produce intermittent obstructive symptoms during sleep. Facial, oral, and throat eccentricities occur in numerous congenital syndromes. Certain storage diseases, hypothyroidism, and Down syndrome result in upper airway crowding due to a relative increase in tongue mass compared to mouth size.

Neuromuscular diseases contribute to obstructive sleep apnea because of abnormal muscle tone in the pharyngeal constrictors, which are responsible for maintaining airway patency. Children with Chiari malformations are usually not weak but may develop obstructive apnea due to dysfunction of the same pharyngeal muscle groups. Individuals with obesity typically have fatty infiltration of the soft tissues of the throat, limiting airway caliber and predisposing them to obstructive apnea. Persons with sickle cell anemia have a tendency toward obstructive apnea for reasons that are still unclear.

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