Causes of obstructive sleep apnoea in children
Obstructive sleep apnoea in children results from an anatomically or functionally narrowed upper airway. The most common cause of obstructive sleep apnoea in children is adenotonsillar hypertrophy. Other causes are listed in Causes of obstructive sleep apnoea in children.
|
Cause |
Comments and examples |
|---|---|
|
adenotonsillar hypertrophy |
most common cause |
|
anatomical abnormalities |
macroglossia and hypertrophy of lingual tonsils in Down syndrome [NB1] craniofacial abnormalities (eg Pierre-Robin sequence, Crouzon syndrome, achondroplasia) |
|
functional abnormalities |
hypotonia of neuromuscular disorders, leading to collapse of upper airway during inspiration hypertonia, commonly seen in cerebral palsy, causing functional narrowing decreased or impaired respiratory drive (eg spina bifida, achondroplasia, Prader-Willi syndrome) |
|
obesity |
may be associated with obstructive sleep apnoea, with or without tonsillar enlargement severely obese children are at risk of developing obesity hypoventilation syndrome |
Note:
NB1: Children with Down syndrome are at increased risk of obstructive sleep apnoea. The estimated prevalence varies widely between 50 and 100%, compared to 1 to 5% in the standard paediatric population. The risk of obstructive sleep apnoea in children with Down syndrome appears to be high independently of the presence of other risk factors (eg adenotonsillar hypertrophy, obesity). All children with Down syndrome, including those without symptoms, should be screened for obstructive sleep apnoea. | |