Does your child breathe with his mouth open when he sleeps? Does he/she snore? Does he/she have a lack of concentration? Is there a decrease in academic performance? …… etc. If you have these symptoms, you should pay attention to whether your child has habitual snoring or even obstructive sleep apnea hypoventilation syndrome (OSAHS). OSAHS in children is a breathing disorder during sleep characterized by prolonged partial obstruction of the upper airway or intermittent complete obstruction (apnea), which disrupts normal ventilation and normal sleep patterns during sleep. The incidence varies from one literature to another, with some reporting about 1%-3% of the total number of children, with no gender differences, and a prevalence age of 2-5 years (Pitsonetal, 1994). The results of the epidemiological survey on sleep status of 3227 children aged 2-6 years in Beijing, China, showed that the incidence of snoring during sleep was 5.5% and sleep apnea was 0.19% (not confirmed by PSG). The clinical symptoms of the children mainly included habitual snoring at night, sleep disorders and/or neurobehavioral problems during the day. Specifically: Nocturnal: sleep breathing disorder: snoring, open mouth breathing, labored breathing during sleep, trismus and even cyanosis of the lips may be present. Sleep restlessness, hyperactivity, excessive sweating, awakening, struggling or sleep panic. Some children have bedwetting. Daytime: hyperactivity, poor academic performance, and developmental delays. A significant proportion of the children showed daytime irritability, irritability, abnormal personality behavior, attention deficits, morning headaches, and poor academic performance. gozal conducted an initial home screening of 297 first graders whose academic performance was in the last 10% of their class and found that 18% had sleep-related respiratory disorders and that children who had adenoid tonsil surgery showed a significant improvement in academic performance the following year, while un treated children showed no change in performance. Common complications of OSAHS in children include neurocognitive impairment, developmental delays, and, especially in severe cases, pulmonary heart disease. Risk factors include adenoid tonsillar hypertrophy, obesity, craniofacial deformities, and neuromuscular disorders. OSAS in children can lead to serious complications such as neurocognitive impairment, developmental delay, behavioral abnormalities, hypertension, pulmonary hypertension and even pulmonary heart disease, and death has been reported. Low weight and short stature in 3/4 of 39 cases have been reported. So what exactly causes snoring and even OSAHS in children? Adenoid and/or tonsillar hypertrophy, the most common. Enlarged tonsils and adenoids can cause snoring, but their enlargement is not the only cause of OSAHS, so OSAHS cannot be diagnosed based on adenoids and tonsils enlargement and snoring history alone. Obesity: obesity is an important factor in the development of OSAHS, less than 15% of children with symptomatic snoring in the early 1990s were obese, and the proportion of symptomatic snoring children in a sleep center in the United States in the past 2-3 years has The proportion of obese children with symptomatic snoring in a sleep center in the United States has increased rapidly by more than 50% in the last 2-3 years, which should be a warning to Chinese parents. Craniofacial developmental abnormalities such as micrognathia (Pirre-Robbin syndrome), Down’s syndrome, and megalingualism are undoubtedly risk factors for OSAHS in children. Others: post-operative cleft palate, true ankylosis of temporomandibular joint, neuromuscular anomalies, traumatic deformities, giant neck masses, etc. How to diagnose and treat snoring or even OSAHS in children? If parents find that their children have the above symptoms, it is recommended to promptly visit a specialist hospital and have the gold standard examination, the all-night polysomnography (PSG) examination, performed at the hospital sleep center. Treatment: For most children with adenoids or/and tonsillar hypertrophy, adenoidectomy and tonsil removal are the most effective treatment modalities with an efficiency of 70-100%. Children who undergo adenoidectomy and/or tonsillectomy regain growth and development, and behavioral and personality abnormalities, learning difficulties, and cardiopulmonary abnormalities often disappear. In addition to surgery, recent research data suggest that topical nasal corticosteroids are effective in reducing the size of the adenoids and improving OSAHS. In children with OSAHS with craniofacial deformities, adenoidectomy or/and tonsil removal alone is not satisfactory and orthodontic treatment should be considered to promote normal craniofacial development. For special conditions such as micromaxillary deformity, Down’s syndrome, and megalingualism, early surgery can be considered to treat the soft and hard tissue deformities of the jaw and face to relieve the more severe OSAHS symptoms in order to avoid serious complications such as pulmonary hypertension and neurological damage in the future. For those who have poor results after surgery, CPAP is well tolerated. Studies have shown that CPAP not only eliminates apnea in infants and children, but also improves sleep slices, and families report that the children’s daytime behavior, alertness and feeding have improved. However, the pressure of the machine has to be adjusted accordingly as the time lengthens. Tracheotomy is feasible for children who are not suitable for the above treatment modalities.