Table 2. Adult versus Pediatric Obstructive Sleep Apnea
Clinical Features of Adult OSASSymptoms and Signs of Pediatric OSAS
Breathing disturbances during sleepNocturnal Symptoms
    Habitual, socially disruptive snoring    Snoring
    Witnessed apneas    Gasping
    Gasping or choking    Noisy breathing (typically inspiratory)
Difficulties maintaining sleep    Paradoxical breathing
    Snort arousals    Retractions (cervical or costal)
    Dyspnea spells    Witnessed apneas
    Restlessness    Restless sleep
    Nocturia    Neck hyperextension
    Diaphoresis    Mouth breathing
    Gastroesophageal reflux    Nocturnal sweating
Daytime dysfunction    Enuresis (after 6 mo continence)
    Nonrestorative sleep
    Excessive daytime sleepiness in a nonstimulating environment (eg, watching TV, reading, riding in/driving a car)
    Parasomnia (walking, talking, terrors) Bruxism Mouth breathing
Daytime Symptoms
    Motor vehicle accidents, especially a history of “falling asleep at the wheel”    Difficulty waking Unrefreshed on waking
    Impaired concentration, cognition, or memory    Excessive sleepiness
    Headaches upon arising    Hyperactivity
    Mood lability    Aggression/moodiness
    Weakened libido    Mouth breathing
Risk factors    Poor appetite
    Obesity    Dysphagia
    Smoking    Difficulty in school
    Nasal congestionSigns/Findings
    Alcohol    Tonsil hypertrophy
    Sedative/hypnotics    High/large tongue position
    Opioid analgesics    Growth disturbance
    Supine (on the back) sleep positioning    Obesity
Comorbidities    Failure to thrive
    Hypertension    Pulmonary hypertension
    Myocardial infarction    Systemic hypertension
    Congestive heart failure    Craniofacial abnormalities
    Stroke    Laryngomalacia
    Pulmonary hypertension    Nasal airway obstruction
    Diabetes/metabolic syndrome    HypotoniaGastroesophageal reflux
  • Column 1 (adult) adapted from Ref. 23. Column 2 (pediatric) reprinted from Ref. 16.

  • OSAS, obstructive sleep apnea syndrome.