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Clinical features

Authoring team

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

(2) Marcus CL et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012;130(3):e714-55.

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

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