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Paradoxical breathing or "paradoxical inward rib cage movements" without frank sleep apnea is a clinical de- scription of the "upper airway resistance syndrome". Upper airway resistance syndrome is thought to be a distinct entity and not just a part of the continuum of obstructive sleep apnea; paradoxical breathing in children appears to be a separate entity from the classic patient with marked adenotonsillar hypertrophy causing obstructive apnea. The treatment also dif- fers. We present a case of paradoxical breathing in a child who resolved spontaneously over a two year period.

Paradoxical Respiration: An indication for Adenotonsillectomy?