aetiology

Last reviewed 01/2018

Obstructive sleep apnoea occurs in three groups of children:

• those with adenotonsillar hypertrophy
• the commonest cause
• 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 (1,2)

Reference:

• (1) Powell S et al. Paediatric obstructive sleep apnoea. BMJ. 2010;340:c1918
• (2) Powell S. Clinical review: Paediatric obstructive sleep apnoea. GPonline 2011