Obstructive sleep apnea is observed in children of all ages and may develop even in infancy. Retrospective studies note that a large number of parents with children in whom obstructive sleep apnea is diagnosed recall that their child's snoring began within the first months of life. Preterm babies are at risk for more obstructive events while supine, but some have suggested that they are still at a lower risk of death from sudden infant death syndrome. However, Moon et al, citing 3 studies, report that premature infants may be at 4 times increased risk for sudden infant death syndrome compared with term infants, with the risk increasing at lower gestational age and birthweight. [4]
Most children with obstructive sleep apnea are aged 2-10 years (coinciding with adenotonsillar lymphatic tissue growth). Children with severe obstructive apnea are likely to present when aged 3-5 years. The mean age at diagnosis has been reported to be 14 months, plus or minus 12 months.
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Palate appearance following uvulopalatopharyngoplasty (UPPP) surgery.
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Example of an obstructive apnea and an obstructive hypopnea recorded during polysomnography.
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Medical complications associated with obstructive sleep apnea in children.
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Compressed overnight polysomnography tracing of a 6-year-old boy who snores, showing multiple events of obstructive apnea (green-shaded areas) associated with oxyhemoglobin desaturation (yellow-shaded areas) and EEG arousals (red-shaded areas).
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Parameters monitored during an overnight pediatric sleep study.
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Normal parameters for sleep gas exchange and gas exchange in children.
