Children are a special group, and their physiology, disease development and regression are very different from those of adults. Obstructive sleep apnea syndrome in children can occur at all ages from infancy to adolescence. Foreign epidemiological studies have reported that 20% of children snore during sleep, of which 10%-12% snore alone, and the incidence of OSAS is 1%-3%. OSAS in children is not an isolated disease, but its development can lead to a series of adverse consequences. Some studies have found that OSAS has a significant impact on the physical development of children, which can lead to slow growth, developmental delay, cardiovascular disease and even death, and other data show that the behavior and recognition ability of children with OSAS are also impaired. The etiology of OSAS in children is significantly different from that of adults, with no significant differences in gender, age, or body mass index. Obesity is a major cause of OSAS in adults, but is not as pronounced in children as in adults. Adenoid and tonsillar hypertrophy is the most common cause of OSAS in children, and studies have shown that 90% of children with OSAS have obstructive planes in the adenohypophysis and tonsillar plane. Unlike in adults, positive pressure ventilation (CPAP) is not appropriate as a routine approach for OSAS in children. The following is a typical case of a recently operated child aged 1 year and 2 months. The child, Wang–, male, had snoring, runny nose, open-mouth breathing, breath-holding, and daytime sleepiness for more than 4 months, and the results of polysomnography monitoring performed by Dr. Huang Yang, deputy chief of our pediatric department, showed a sleep apnea index of 34 and a minimum blood oxygen of 50%, which means that the child had 34 sleep apnea hypoventilation per hour during nighttime sleep and was severely hypoxic during sleep. In one case, the child had apnea for more than 3 to 4 minutes, and in an emergency, they called 110 for help. Then, it is necessary to understand the concept of apnea and hypoventilation. Obstructive apnea is defined as the presence of chest and abdominal movements and the cessation of oral and nasal airflow for more than two respiratory cycles; hypoventilation is defined as a decrease in peak oral and nasal airflow of more than 50% for at least two respiratory cycles and a decrease in blood oxygen saturation of more than 4%. A single apnea event in children is defined as a cessation of oronasal airflow for greater than or equal to 5 seconds, and hypoventilation is defined as a 50% decrease in oronasal airflow amplitude for more than 5 seconds. Therefore, this child had apnea for more than 170 seconds per hour of sleep time. Based on the above history, the diagnosis of severe OSAS in a child was clear, and we then performed a comprehensive physical examination of the child and a CT examination of the nose and a nasopharyngeal fiberoptic laryngoscopy of the upper airway. We could see that the CT showed significant sinusitis and a rather narrow airway in the soft palate plane of the nasopharynx. The nasopharyngeal fiberoptic laryngoscopy images also showed severe airway narrowing in the nasopharyngeal and soft palate planes (see fiberoptic laryngoscopy Figs. 1-5), and nasopharyngeal fiberoptic laryngoscopy Figs. 1 and 2 showed adenoid hypertrophy with purulent secretions and narrowing of the nasopharyngeal airway. The nasopharyngeal fiberoptic laryngoscopy showed a clear airway in the oropharynx, tonsil plane, and tongue and larynx planes. We had reason to believe that the child’s condition could be improved or even cured after the surgery, and the operation went smoothly with the excellent cooperation of the operating room nurses and anesthesiologists. After the operation, the child was discharged from the hospital with apnea eliminated, slight snoring, and a minimum oxygen saturation of over 94%. This case also gives us a hint that this kind of upper airway obstruction should be treated and operated actively when the cause is clear, and there is no need to stick to the age. After many years of efforts, we can say that our hospital has reached the same leading level in diagnosing and treating sleep disorders in children in China, while the efficiency and safety of anesthesia and the cooperation of surgical nurses are also the guardians of our development.