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)

Reference:

(1) Giuca MR, et al. Pediatric Obstructive Sleep Apnea Syndrome: Emerging Evidence and Treatment Approach. ScientificWorldJournal. 2021 Apr 23;2021:5591251.

(2) Powell S et al. Paediatric obstructive sleep apnoea. BMJ. 2010;340:c1918

(3) Powell S. Clinical review: Paediatric obstructive sleep apnoea. GPonline 2011