**19. Pediatric and adolescent obstructive sleep apnea**

Obstructive sleep apnea in pediatric and adolescent patients is characterized by episodic partial or complete upper airway obstruction during sleep. All children with OSAS snore. It has been estimated to occur in 5–6% of children. It is most seen in preschool children; the peak age is 3–6 years, which coincides with the growth of adenoids and tonsils. Pediatric OSAS is similar to adult OSAS, but there are differences. Sleep disruption occurred by respiratory pauses less than ten seconds. Hypopneic episodes can be seen, usually more than five to ten episodes per night with oxygen saturations less than 85%. Pediatric OSAS effects both gender at the same ratios, different from adult OSA. Seven percent to nine percent of children snore every night; 18% of them snore in nasal, ear, or throat infection periods. The prevalence of pediatric OSAS is estimated about 0.5–3%. AHI scores of pediatric sleep apnea is controversial. Some protocols of AHI score greater than 1 should be accepted as a pediatric OSA predictor; some protocols accepting AHI score greater than 5 is pathognomonic.
