Clinical features
Clinical features differ from the adult form of the condition.
- while daytime sleepiness and snoring are predominant features in adult OSA, in children tiredness is not a prominent symptom (1).
Symptoms and signs of OSAS in children include (nocturnal and diurnal):
- frequent snoring (>=3 nights/wk)
- labored breathing during sleep
- gasps/snorting noises/observed episodes of apnea
- sleep enuresis (especially secondary enuresis) - enuresis after at least 6 months of continence
- sleeping in a seated position or with the neck hyperextended
- cyanosis
- headaches on awakening
- daytime sleepiness
- attention-deficit/hyperactivity disorder
- learning problems
Physical examination:
- underweight or overweight
- tonsillar hypertrophy
- adenoidal facies
- micrognathia/retrognathia
- high-arched palate
- failure to thrive
- cor pulmonale or pulmonary hypertension - in severe cases
Reference:
(1) Powell S et al. Paediatric obstructive sleep apnoea. BMJ. 2010;340:c1918
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