Diagnosis and pathophysiology of obstructive sleep apnea in children.

Factors that decrease pharyngeal size or increase pharyngeal compliance increase an individual's risk for OSA. In children, these factors include craniofacial disorders, central nervous system problems, or simply adenotonsillar hypertrophy. Although children with OSA may present with nocturnal symptoms of snoring, respiratory pauses, secondary enuresis, and/or nightmares, their initial complaint may be poor school performance, hyperactivity, or other symptoms of sleep fragmentation. The diagnosis is confirmed by overnight polysomnography in a laboratory with expertise in the care of infants and children.