Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is characterized by intermittent episodes of upper airway collapse during sleep. The pathophysiology of this disorder in children is multifactorial, but two risk factors include adenotonsillar hypertrophy and obesity. Pediatric OSA affects 2 to 3 percent of school age children in the United States. This disease entity has been linked to metabolic changes, cardiovascular sequelae, behavioral problems, and poor cognitive function in children.

Polysomnography (PSG) is currently the gold standard for diagnosis of pediatric OSA. PSG is commonly referred to as a “sleep study” and consists of an electrographic recording of various physiologic parameters including: stages of sleep, airflow, respiratory effort, and oxygenation status. PSG reliably measures the presence of OSA and provides an objective scale for OSA severity. The severity of OSA is categorized according to the obstructive apnea hypopnea index (AHI) on PSG. According to the most commonly utilized system, an AHI between 1 and 5 indicates mild OSA, while an AHI greater than 10 is diagnostic of severe OSA.