Pathophysiology of childhood obstructive sleep apnea: current concepts

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Published on: December 6, 2016

C L Marcus1

  • 1The Eudowood Division of Pediatric Respiratory Sciences, Park 316, Johns Hopkins University, Baltimore, 600 N Wolfe Street, Baltimore, MD, USA. cmarcus@welch.jhu.edu

Respiration Physiology
|March 21, 2000
PubMed

Insights

Obstructive sleep apnea syndrome (OSAS) in children is common but poorly understood. It may occur in children with underlying upper airway issues who lack compensatory neuromotor responses during sleep.

Area of Science:

  • Pediatric pulmonology
  • Sleep medicine
  • Otolaryngology

Background:

  • Obstructive sleep apnea syndrome (OSAS) is a prevalent and serious childhood condition.
  • The exact pathophysiology of pediatric OSAS is not fully understood.
  • Adenotonsillar hypertrophy is often associated with, but not the sole cause of, pediatric OSAS.

Purpose of the Study:

  • To explore the underlying mechanisms contributing to obstructive sleep apnea syndrome in children.
  • To investigate the role of upper airway function and neuromotor responses in pediatric OSAS.

Main Methods:

  • This study is based on a review of existing literature and current understanding of pediatric OSAS pathophysiology.
  • Analysis of the interplay between upper airway anatomy, neuromotor control, and ventilatory drive during sleep.

Main Results:

  • While large tonsils and adenoids can precipitate OSAS, they likely do so in children with pre-existing upper airway functional abnormalities.
  • Children with OSAS may lack the necessary compensatory upper airway neuromotor responses that maintain airway patency during sleep.
  • Normal children maintain airway patency through increased upper airway neuromotor tone and central ventilatory drive during sleep.

Conclusions:

  • Pediatric OSAS pathophysiology involves more than just adenotonsillar hypertrophy.
  • A deficit in compensatory upper airway neuromotor responses may be a key factor in the development of OSAS in susceptible children.
  • Further research into upper airway neuromotor function is warranted to better understand and treat pediatric OSAS.

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