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.