Paediatric OSA affects a large number of children and has multiple end-organ sequelae. The prevalence of obstructive sleep apnoea (OSA) in the paediatric population is approximately 3% and has been reported as high as 59% in children with obesity. 1 Paediatric obstructive sleep apnoea (OSA) is characterised by snoring, apnoeas, intermittent hypoxia and hypercapnia, sleep fragmentations, frequent arousals and circadian rhythm disturbances. These OSAinduced issues result in a variety of end-organ manifestations with effects on the heart, lungs, brain, gut microbiome and genitourinary systems. While many of these have been demonstrated to be reversible, the effects on some of the organ systems, including the brain, have not shown easy reversibility. Specifically, children sleep