Pilot Study of a Self-Supporting Nasopharyngeal Airway in Hypotonia

Inclusion Criteria: * Children with HUAO: This includes those who newly diagnosed with OSA. These children will undergo overnight polysomnography to determine the presence of OSA (AHI\>10 or AHI\>5 with nocturnal hypoxemia defined as SpO2 nadir \<=75%). * Obstructive sleep apnea on polysomnogram with AHI\>=10 * Presence of at least one symptom of OSA (such as snoring 3 or more nights per week, daytime sleepiness, or hyperactive/inattentive behaviors) * Post adeonotonsillectomy or those with contraindications to tonsillectomy. * obstructive sleep apnea on polysomnogram with AHI\>=10 * Tonsil size 2+ or smaller * Parent/caregivers willing and able to provide informed consent and child willing and able to provide assent, where appropriate. Exclusion Criteria: * AHI ≤10 on polysomnogram without hypoxemia or AHI\<5 with hypoxemia - any reason why ssNPA may not be suitable * Any medical reason why ssNPA therapy may not be suitable * Active COVID 19 infections * ETCO2 or TCO2 values \>60 mmHg for \>10% of sleep time on PSG * Psychiatric, medical, or social factors likely to invalidate assessments, make adherence with ssNPA highly unlikely or make local follow-up at 8 weeks unfeasible. Some psychiatric conditions may be provoked or exacerbated by OSA, and those most commonly implicated - Attention Deficit/Hyperactivity Disorder, Conduct Disorder, and Oppositional Defiant Disorder - will not be exclusions. However, more pervasive conditions such as severe autism will be excluded * …