title: Pediatric obstructive sleep apnea: complications, management, and long-term outcomes.
abstract: Obstructive sleep apnea (OSA) in children has emerged not only as a relatively prevalent condition but also as a disease that imposes a large array of morbidities, some of which may have long-term implications, well into adulthood. The major consequences of pediatric OSA involve neurobehavioral, cardiovascular, and endocrine and metabolic systems. The underlying pathophysiological mechanisms of OSA-induced end-organ injury are now being unraveled, and clearly involve oxidative and inflammatory pathways. However, the roles of individual susceptibility (as dictated by single-nucleotide polymorphisms), and of environmental and lifestyle conditions (such as diet, physical, and intellectual activity), may account for a substantial component of the variance in phenotype. Moreover, the clinical prototypic pediatric patient of the early 1990s has been insidiously replaced by a different phenotypic presentation that strikingly resembles that of adults afflicted by the disease. As such, analogous to diabetes, the terms type I and type II pediatric OSA have been proposed. The different manifestations of these two entities and their clinical course and approaches to management are reviewed.
authors.affiliation: Department of Pediatrics, University of Louisville, Kentucky, USA.
authors.forename: Oscar Sans
authors.initials: OS
authors.lastname: Capdevila
authors.forename: Leila
authors.initials: L
authors.lastname: Kheirandish-Gozal
authors.forename: Ehab
authors.initials: E
authors.lastname: Dayyat
authors.forename: David
authors.initials: D
authors.lastname: Gozal
mesh_terms: D002648:Child; D006801:Humans; D010641:Phenotype; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000145:classification / Q000150:complications* / Q000503:physiopathology / Q000628:therapy