Related Experiment Video
Updated: Dec 30, 2025
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Obstructive sleep apnea in developmental age. A narrative review
Anna Lo Bue1, Adriana Salvaggio2, Giuseppe Insalaco2
1National Research Council of Italy, Institute for Biomedical Research and Innovation, Via Ugo La Malfa, 153, 90146, Palermo, Italy. anna.lobue@irib.cnr.it.
Insights
Obstructive sleep apnea (OSA) in children differs significantly from adults, impacting developing brains more severely. Prompt diagnosis and treatment are crucial to prevent long-term neurocognitive and physical deficits in children.
Area of Science:
- Pediatric Sleep Medicine
- Neurodevelopmental Disorders
- Respiratory Physiology
Background:
- Sleep undergoes significant neurophysiological and behavioral variations across different life stages.
- Childhood development involves continuous physical, neuropsychological changes, and synaptic remodeling during sleep, underpinning brain plasticity.
- Obstructive sleep apnea (OSA) in children presents unique characteristics compared to adults, with diagnostic criteria differing significantly.
Purpose of the Study:
- To provide a narrative review of obstructive sleep apnea (OSA) in developmental age.
- To highlight the variability and age-specific nature of pediatric OSA.
- To compare and analyze OSA across different age groups throughout life.
Main Methods:
- This study is a narrative review.
- It synthesizes existing literature on obstructive sleep apnea in developmental age.
- The review compares clinical manifestations, diagnostic, and therapeutic criteria across pediatric and adult populations.
Main Results:
- Adenotonsillar hypertrophy is a primary risk factor for pediatric OSA, with obesity increasingly prevalent, especially in early childhood and adolescence.
- OSA significantly affects cognitive function in children, potentially altering neuro-psychic development, learning, and social interactions due to its impact on plastic brain structures.
- Diagnostic thresholds for OSA, such as an apnea-hypopnea index (AHI) of 5, differ between pediatric and adult populations, with a lower threshold in children indicating a need for therapeutic intervention.
Conclusions:
- Obstructive sleep apnea (OSA) is a prevalent disorder in children requiring prompt identification and management.
- Untreated pediatric OSA can lead to serious cardiovascular, metabolic, and neurocognitive morbidities.
- Early intervention is critical to prevent potentially irreversible deficits during crucial developmental periods.
Abstract:
Sleep is a physiological function that undergoes, at different stages of life, to considerable variations in neurophysiological and behavioral functions. The developmental age is a period characterized by a continuous process of physical and neuropsychological changes and synaptic remodeling processes that are the neurophysiological basis of brain plasticity, typical of this developmental phase, occurring mainly during sleep. In the description of obstructive sleep apnea (OSA) in children, two main points should be highlighted: its variability in different age groups, and its specificity compared with OSA in adults. The definition and criteria used for the diagnosis of OSA in adults are not applicable to OSA in developmental age. Although the adenotonsillar hypertrophy is the most common risk factor for pediatric OSA, obesity is becoming an increasingly prevalent risk factor, mostly in early childhood (6-9 years) and adolescence. OSA has been shown to affect cognitive function in children and adults. However, OSA impact on cognitive function in children is more severe since acting on the plastic brain structures can change the neuro-psychic development, learning skills, and social interactions. There is a clear difference in the definition of pathology between developmental age and adulthood according to the instrumental parameters: an AHI ≥ 5, which represents, in the pediatric age, the cut-off for a therapeutic pathway necessary to avoid a long-term effect on the child, instead, it represents in adulthood, the lower limit value for the definition of disease. This is a narrative review concerning obstructive sleep apnea in developmental age.Conclusions: OSA is a common disorder in children and those at risk must be identified, studied, and treated promptly because untreated OSA can be responsible for cardiovascular, metabolic, and neurocognitive morbidities and may induce, sometimes, non-reversible deficits given his insistence on a period of physical and neuro-psychic development.What is Known:•This is a review concerning Obstructive Sleep Apnea in developmental age•Clinical manifestation, diagnostic and therapeutic criteria of sleep apnea in developmental ageWhat is New:•This is a "narrative" review•This narrative review describes sleep apnea comparing and analyzing the different ages of life.
