Children with craniofacial syndromes, especially those with midfacial hypoplasia, micrognathia, or deformation of the cranial base, are frequently suffering from obstructive sleep apnea syndrome (OSAS). It is important to recognize this condition. Diagnostic methods and therapeutic developments are discussed. Experience with 31 patients in the Sophia Children's Hospital is presented. The majority of these infants suffered from moderate or severe OSAS. Treatment varied from symptomatic (e.g. continuous positive airway pressure) to curative. These therapies could often prevent a tracheotomy. Still more curative treatment options are needed.