ABSTRACT
Sleep-disordered breathing (SDB) is characterised by a total cessation of airflow (apnoea) or substantial reduction of airflow (hypopnoea) in breathing during sleep and encompasses the full spectrum of primary snoring, upper airway resistance syndrome and obstructive sleep apnoea (OSA). Primary snoring is reported in 5-10% of children and OSA in 1-5%.[1] Approximately one-third of children with obesity will have OSA or report symptoms of OSA.[2, 3] Obesity possibly plays a more important role in the pathogenesis of OSA in older children and adolescents than in younger children, in whom adenotonsillar hypertrophy features more strongly.[4] There is no clear definition of the age at which obesity begins to influence OSA risk, but one study reports that increased risk of developing OSA due
to being overweight or obese is predominantly found among adolescents age ≥12 years, with little increase in risk noted among children younger than 12 years.[5] Well-established neurobehavioural morbidities associated with OSA in children include daytime sleepiness,[6, 7] lower intelligence and memory scores,[7, 8] increased problem behaviours[7, 9-11] and poorer executive functioning.[4, 9-11] Previous research has also documented improvements in children’s overall behaviour and neurocognitive function following treatment of SDB,[12, 13] although research in older children and adolescents is not so well established.
