The Rubinstein-Taybi syndrome is characterized by a pattern of malform
ations including broad thumbs and big toes, microcephaly, facial dysmo
rphism, small stature, and mental retardation. Obstructive sleep apnea
(OSA), has been described in several facial or skeletal malformations
, but never in the Rubinstein-Taybi syndrome. We studied a 9-year-old
boy, previously diagnosed as having the Rubinstein-Taybi syndrome and
affected by severe OSA, as documented by polysomnography. He manifeste
d the habitual and heavy snoring with breathing difficulties at night,
and excessive daytime sleepiness. Short neck and obesity were importa
nt factors for the severity of the syndrome. Continuous positive airwa
y pressure was not tolerated and weight loss was the only possible tre
atment, as upper airway surgery was not indicated by cephalometric, ot
olaryngologic or clinical results.