racial/ethnic groups. In adults, the male-to-female ratio of obstructive sleep apnea hypop-
nea ranges from 2:1 to 4:1. Ge nder differences decline in olde r age, possibly because of an
increased prevalence in females after menopause. There is no gender difference among
prepubertal children.
Development and Course
The age distribution of obstructive sleep apnea hypopnea likely follows a J-shaped distri-
bution. There is a peak in children ages 3–8 years when the nasopharynx may be compro-
mised by a relatively large mass of tonsillar tissue compared with the size of the upper