ABSTRACT

Sleep apnea-hypopnea syndrome (SAHS) affects 1% of the pediatric population and is independently associated with deficits in neuropsychological and behavioral functions, high cardiovascular risk, and disturbances in the glucose metabolism. Disproportion between airway size and lymphoid tissue growth contributes to the appearance of SAHS; however, current knowledge on pharynx physiology during sleep has helped to clarify the reason why in the majority of cases the enlargement of tonsils and adenoids per se is not enough to cause SAHS. The adequate functioning of pharynx’s dilator muscles is an adaptive neuromuscular pathway that allows the upper airway to remain permeable under different circumstances, including the exaggerated negative pressure imposed by the lymphoid tissue. Malfunctioning of this adaptive pathway is the cornerstone of SAHS physiopathology in children. Other factors involved in the physiopathology of SAHS in children are obesity and craniofacial malformations. This article reviews the physiopathological mechanisms of SAHS in children.

KEYWORDS

Sleep apnea, physiopathology, children, obesity.

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