Aetiology
Obstructive sleep apnoea occurs in three groups of children:
- those with adenotonsillar hypertrophy
- main issue correlated with OSA in children (1)
- often there is no underlying medical diagnosis
- peak incidence is seen in children aged 3 to 6 years (which coincides with the time when the adenoids and tonsils undergo hypertrophy)
- those who are obese
- pathogenesis is multifactorial
- exact mechanism is unclear but pharyngeal adipose tissue and decreased respiratory capacity are thought to contribute
- those who have congenital abnormalities
- Down's syndrome
- OSA may be caused by an abnormally narrow upper airway and reduced pharyngeal muscle tone.
- regular screening for obstructive sleep apnoea is recommended since around two thirds of children will have have some form of sleep disordered breathing
- neuromuscular disease
- craniofacial abnormalities
- achondroplasia
- mucopolysaccharidoses
- Prader-Willi syndrome (2,3)
- Down's syndrome
Reference:
(2) Powell S et al. Paediatric obstructive sleep apnoea. BMJ. 2010;340:c1918
(3) Powell S. Clinical review: Paediatric obstructive sleep apnoea. GPonline 2011
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