{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:45:09Z","timestamp":1787028309621,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T00:00:00Z","timestamp":1589760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Upper airway abnormalities increase the risk of pediatric morbidity in infants. A multidisciplinary approach to obstructive sleep apnea syndrome (OSAS) poses challenges to clinical practice. The incidence and causes of OSA are poorly studied in children under 2 years of age. To fill this gap, we performed this retrospective observational study to determine the causes of obstructive sleep apnea (OSA) in children admitted to our hospital between January 2016 and February 2018, after a brief unexplained event (BRUE) or for OSA. We reviewed the medical charts of 82 patients (39 males; BRUE n = 48; OSAS n = 34) and divided them into two age groups: &lt; 1 year old (1\u201312 months; n = 59) and &gt;1 year old (&gt;12\u201324 months; n = 23). Assessment included nap polysomnography, multichannel intraluminal impedance-pH, and nasopharyngoscopy. Sleep disordered breathing was comparable between the two groups. Omega-shaped epiglottis, laryngomalacia, and nasal septum deviation were more frequent in the younger group, and nasal congestion in older group. Tonsillar and adenoidal hypertrophy was more frequent in the older group, while laryngomalacia and gastroesophageal reflux was more frequent in the younger group. Tonsil and adenoid size were associated with grade of apnea-hypopnea index severity in the older group, and laryngomalacia and gastroesophageal reflux in the younger group. The main causes of respiratory sleep disorders differ in children before or after age 1 year. Our findings have potential clinical utility for assessing the pathophysiology of obstructive sleep disordered breathing in patients less than 2 years old.<\/jats:p>","DOI":"10.3390\/ijerph17103531","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T11:34:14Z","timestamp":1589801654000},"page":"3531","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Age and Upper Airway Obstruction: A Challenge to the Clinical Approach in Pediatric Patients"],"prefix":"10.3390","volume":"17","author":[{"given":"Nosetti","family":"Luana","sequence":"first","affiliation":[{"name":"Division of Pediatrics, \u201cF. Del Ponte\u201d Hospital, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8659-5505","authenticated-orcid":false,"given":"Zaffanello","family":"Marco","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"De Bernardi","family":"Francesca","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piacentini","family":"Giorgio","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Giulia","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, \u201cF. Del Ponte\u201d Hospital, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Silvia","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, \u201cF. Del Ponte\u201d Hospital, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simoncini","family":"Daniela","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, \u201cF. Del Ponte\u201d Hospital, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9912-3232","authenticated-orcid":false,"given":"Pietrobelli","family":"Angelo","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy"},{"name":"Pennington Biomedical Research Center, Baton Rouge, LA 225, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agosti","family":"Massimo","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Neonatal Intensive Care Unit, \u201cF. Del Ponte\u201d Hospital, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/HJH.0000000000001123","article-title":"Sleep-disordered breathing is associated with blood pressure and carotid arterial stiffness in obese children","volume":"35","author":"Tagetti","year":"2017","journal-title":"J. Hypertens."},{"key":"ref_2","unstructured":"(2002). Clinical practice guideline: Diagnosis and management of childhood obstructive sleep apnea syndrome. Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. American Academy of Pediatrics. 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