Sleep Apnea in Children and the Upper Airway: Comorbid and Coexisting
- DOI:
- 10.1093/med/9780199918065.003.0005
Obstructive sleep apnea (OSA) is the most severe form of “obstructive sleep-disordered breathing,” a spectrum of abnormal respiratory patterns during sleep characterized by snoring and increased respiratory effort due to increased upper airway resistance and pharyngeal collapsibility. Adenotonsillar hypertrophy and obesity are the most frequent causes of OSA in children. The clinical manifestations of OSA include apneas (cessation of oronasal airflow) and hypopneas (reduction of airflow), accompanied by arousals from sleep, restless sleep, daytime symptoms (sleepiness, inattention, hyperactivity), and academic difficulties. Cysteinyl leukotrienes contribute to the pathogenesis of both asthma and OSA in childhood. Cysteinyl leukotrienes have also been implicated in the pathogenesis of adenotonsillar hypertrophy. Preliminary evidence suggests that treatment of sleep apnea with adenotonsillectomy results in improved control of coexisting asthma.
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