Issue 2/2025
Nencheva-Milichevich, D., Petrova, G.
Pediatrics Clinic, University Hospital „Alexandrovska” – Sofia
Obstructive sleep apnea (OSA) in childhood is a socially significant condition with a high prevalence and serious complications for untreated patients. OSA is characterized by recurrent episodes of partial or complete obstruction of the upper airway during sleep. The prevalence of OSA in school-aged children varies between 1% and 5%, with the main risk factors in this age group being adenotonsillar hypertrophy and obesity. Desaturation, hypercapnia, and sleep fragmentation trigger inflammatory cascades, oxidative stress, and impaired sympathetic activity. The cardiovascular system is primarily affected, with manifestations including endothelial dysfunction, blood pressure dysregulation, and cardiac remodeling. Additionally, children with OSA and obesity are at increased risk of neurocognitive impairments and metabolic syndrome. The gold standard for diagnosing OSA is polysomnography, conducted in a specialized sleep laboratory. In children with OSA and adenotonsillar hypertrophy the first-line treatment is adenotonsillectomy.
Key words: obstructive sleep apnea, apnea-hypopnea index, polysomnography, adenotonsillectomy
Address for correspondence:
Dr. D. Nencheva-Milichevich
University Hospital „Aleksandrovska“,
Clinic of Pediatrics
1, St. Georgi Sofiyski St.
1000, Sofia
e-mail: diana_nencheva@yahoo.com