ABSTRACT
As in adults, sleep-related breathing disorders (SRBD) in children are characterized by episodic obstruction of airflow through the upper airway during sleep. Children with SRBD often demonstrate decreased caliber of the airway due to skeletal anatomy, compliant or excessive pharyngeal soft tissues, or neuromuscular compromise, complicated by the diminished muscle tone and neurophysiologic changes that typically accompany sleep. Attempts to overcome the obstruction by increasing respiratory effort often exaggerate collapse of the airway, resulting in a paradoxical increase in resistance to airflow. The physiologic sequelae may include hypoxemia, hypercapnia, and acidosis, which in turn signal central and peripheral chemoreceptors and baroreceptors to initiate the arousals and sudden pharyngeal dilation that characterize SRBD.
