What is the most common cause of obstructive sleep apnea (OSA) in children?

Correct answer: D. Enlarged tonsils and adenoids (adenotonsillar hypertrophy)

• A. Obesity is the most common cause of OSA in ADULTS, not children. While obesity can contribute in children, it is not the primary pediatric cause.
• B. Trisomy 21 (Down syndrome) is associated with hypotonia, macroglossia, and midfacial hypoplasia — which contribute to OSA — but Down syndrome is not the most COMMON cause of pediatric OSA.
• C. Low birth weight is associated with developmental complications but is not the primary cause of pediatric OSA.
• D. Correct. In children, the most common cause of OSA is adenotonsillar hypertrophy (enlarged tonsils and adenoids), which obstructs the upper airway during sleep. Adenotonsillectomy is often curative.