Introduction
The prevalence of Obstructive Sleep Apnea (OSA) in children under 5 years is around 3%, with a peak incidence between 2 and 5 years1, being much less frequent in the case of central sleep apnea syndrome (CSAS).
Combinations of anatomical and functional factors influence the pathogenesis of childhood OSA. Among the causes of CSAS, diseases of the central nervous system, alterations of the brainstem (tumors, malformation of Chiari type I and type II, stenosis of the foramen magno) and the use of sedative or narcotic medication stand out1, 3.
The current diagnostic reference method for any SDB in children is Polysomnography (PSG), although Cardiorespiratory Polygraphy (CRP) could also be performed if necessary as a first diagnostic approach if the symptomatology is highly suggestive. Other diagnostic methods are also useful for knowing the etiology of SDB such as brain MRI4.
The treatment of OSA in children is mainly based on the etiology of the disease. In the case of CSAS, the treatment of choice is that of the underlying pathology, so its identification is essential3,4,5.
Here, we describe a childhood patient with a diagnosis of moderate mixed OSA of central predominance, whose probable etiology, Arnold Chiari Type I syndrome, was discovered by performing a brain MRI. This case provides a bibliography on how to act and what steps to follow when diagnosing a CSAS in childhood.