of concern. Children with obstructive sleep apnea hypopnea also may present with failure to
thrive and developmental delays. In young children, obesity is a less common risk factor,
while delayed growth and “failure to thrive” may be present.
Risk and Prognostic Factors
Genetic and physiological. The major risk factors for ob structive sleep apnea hypopnea
are obesity and male gender. Others include maxillary-mandi bular retrognathia or micro-
gnathia, positive family history of sleep apnea, genetic syndromes that reduce upper
airway patency (e.g., Down’s syndrome, Trea cher Collin’s syndrome), adenotonsillar hy-