In children, obstructive sleep apnea (OSA) verified by polysomnography represents a serious disorder characterized by intermittent cessation of breathing accompanied by gas exchange abnormalities, snoring, gasping, restlessness, and frequent awakenings due to repeated closure or narrowing of the upper airway. If OSA is unrecognized or left untreated, significant morbidity can result, including failure to thrive and severe cardiovascular problems, along with daytime behavioral issues, including disruption in attention and learning, hyperactivity, aggression, and antisocial behavior.1 Obstructive sleep apnea is relatively common among children, with a prevalence of approximately 2%.2 Adenotonsillar hypertrophy accounts for most cases of OSA in children, although children with craniofacial abnormalities, morbid obesity, and neurological disorders affecting upper airway patency also may develop OSA. Adenotonsillectomy results in 75% to 100% polysomnographic-defined resolution of OSA,2 but success with this procedure may become more limited as children become increasingly overweight.3
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