Journal List > Allergy Asthma Respir Dis > v.5(1) > 1059278

Jee: Upper airway and obstructive sleep apnea in children

Abstract

Obstructive sleep apnea (OSA) is characterized by a disorder of breathing with prolonged partial and/or complete airway obstruction which causes frequent arousal during sleep. The prevalence of OSAS is approximately 2%–3.5% in children. It is mainly caused by enlarged tonsils and adenoids. Obesity, craniofacial abnormality, and neuromuscular disease are also relevant predisposing factors. Snoring is the most common presenting complaint in children with OSA, but the clinical presentation varies according to age. The pathogenesis of OSA is complex and involved in multifactorial, relative roles of anatomic and neurohumoral factors. The role of the nose is considered a component of the pathophysiology of OSA. It is unlikely that the first manifestation of OSA is intermittent snoring with nasal obstruction, often considered a coincidental finding. Childhood OSA should be diagnosed and treated, if clinically suspected, because various symptoms, signs, and consequences can be improved with proper management. Adenotonsillectomy is the first-line treatment modality in pediatric OSA with adenotonsillar hypertrophy. In addition, treatment of allergic rhinitis, nonallergic rhinitis, and other structural problems of the nasal cavity, if it is needed, may be included in the treatment of OSA.

Figures and Tables

Fig. 1

The upper airway in obstructive sleep apnea: a reliance on upper airway dilator muscles for patency. Arrows indicate overall force vector and are shown on diagram. Upward directed arrows (red) signify force vectors for levator palatini and tensor veli palatine muscles in raising the soft palate (uvula) and lateral walls. Because the pharynx is collapsible at all tangents, multiple muscle groups must act in concert to prevent collapse of the pharynx. NP, nasopharynx; OP, oropharynx; HP, hypopharynx. Adapted from Dempsey et al. Physiol Rev 2010;90:47-112, with permission of American Physiological Association.11

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Hye Mi Jee
https://orcid.org/http://orcid.org/0000-0003-0128-065X

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