Il sonno e le apnee: dall'età evolutiva all'età adulta

Sleep is one of the physiological functions that meets, in the different stages of life, to considerable variations in neurophysiological and behavioral functions. The developmental age is a period characterized by a continuous process of physical and neuro-psychological changes and synaptic remodeling processes that are the neurophysiological basis of brain plasticity, typical of this developmental phase, occurring mainly during sleep. In the description of obstructive sleep apnea syndrome (OSAS) in children two basic points should be highlighted: its variability in different age groups and its specificity compared to OSAS in adults, so as the definitions and criteria used for the diagnosis of OSAS in adults are not applicable to childhood. Although the adeno-tonsillar hypertrophy is the most common risk factor for pediatric OSAS, obesity is becoming an increasingly prevalent risk factor, mostly in early childhood (6-9 years) and adolescence. OSAS has been shown to affect cognitive function in children and adults. However, OSAS impact on cognitive function in children is more serious since, acting on the plastic brain structures, can change the neuro-psychic development, learning skills and social interactions. There is a clear difference in the definition of pathology between developmental age and adulthood according to the instrumental parameters: an AHI index equal to 5, which in childhood is the cut-off for a course of treatment needed to prevent long term consequences, in adulthood, is the lower limit value for the definition of pathology.