The pathophysiology of pediatric obstructive sleep apnea (OSA) still is not well understood. Important risk factors are tonsils and adenoids hypertrophy, craniofacial anomalies, neuromuscular diseases and obesity. Multiple factors are involved in the OSA pathophysiology including upper airway (UA) anatomy, pahryngeal collapsibility, neuromuscular compensation, UA protective reflex, lung volume, arousal threshold and ventilatory control. These mechanisms contribute differently between afflicted individuals. However, most relevant mechanism of pediatric OSA would be that an anatomically narrow UA collapses due to insufficient pharyngeal dilator muscle activity during sleep to maintain UA patency.
(Rev Esp Ortod. 2012;42(3):142-147)