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Aetiology

Authoring team

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

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