Because sympathomimetic amines have been shown to inhibit leptin gene expression,14 it had been suggested that leptin levels in adults with OSA may be low secondary to the high SNSA, the inherent sleep deprivation that OSA causes, and the fact that leptin elicits a decrease in appetite.38 However, as in adults with OSA who have both high SNSA and high leptin levels,39–41 we found that this group of children also had both increased SNSA and leptin, as compared with the non-SDB group. Here, LEP is linked to obstructive sleep apnea syndrome.