Paediatric origins of adult lung diseases

Obstructive sleep apnoea (OSA) and central sleep apnoea have been identified and described in adults, children, and infants. It is not certain, however, if the adult sleep apnoea syndromes, particularly OSA, originate from childhood or whether paediatric and adult sleep apnoea are separate syndromes. Some investigators have suggested that the pathophysiology, criteria for diagnosis, and the management of paediatric patients with OSA are diVerent from that for adults. Other investigators have found that risk factors, clinical symptoms, and the consequences of OSA share common features between adults, children and infants. We propose that the adult sleep apnoea syndrome is related to sleep apnoea in children, and that adult patients with sleep apnoea have been predisposed to developing apnoea since early infancy. The diVerences in OSA in patient populations of diVerent age groups may represent diVerent stages in the development of the adult form of OSA. This review will discuss the similarities and diVerences between adult, childhood and infant sleep apnoea, particularly OSA. The risk factors, potential mechanisms, and familial factors of OSA will be presented to ascertain the possible genesis of adult sleep apnoea during childhood.