INTRODUCTION
Obstructive sleep apnoea (OSA) is part of a spectrum of sleep-disordered breathing diseases. This ranges from benign simple snoring, affecting up to 12% of children, to severe upper airways resistance and OSA, which affects 1–2% of children.1 Paediatric OSA can be associated with serious consequences including cor pulmonale, right ventricular hypertrophy, and systemic hypertension, if left untreated.1,2
The majority of paediatric OSA is caused by adenotonsillar hypertrophy in children with no pre-existing medical conditions; this is known as ‘uncomplicated OSA’.1 ‘Complicated OSA’ refers to a subgroup of children with medical conditions predisposing to OSA (Table 1); obesity is an important predisposing condition.3 Traditionally, paediatric OSA occurs among pre-school children, although there is an emerging peak in middle childhood and adolescence attributed to the rising obesity epidemic.3 OSA affects boys and girls in equal numbers.1
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Presentation of the paediatric form of the disease differs from adult OSA, as children are more likely to present with behavioural problems, poor attention, and reduced academic performance than daytime sleepiness.2,4 It is therefore important to be vigilant for OSA, take an otolaryngology history, and specifically ask about snoring and other common symptoms, especially in children who are …