The mechanisms for sleep-disordered breathing (SDB) in children are complex and share many of the etiologic risk factors with adults. Professionals who evaluate and treat children with SDB should be cognizant of comorbid risk factors associated with this disorder. Cardiovascular risk is a primary risk factor for SDB in children as in adults. Waist circumference and BMI are the consistent independent risk factors across several thresholds of severity of SDB. This finding suggests that, in children as in adults, metabolic and inflammatory factors may be an important mechanism in the development of SDB, implying that adenotonsillectomy may not always be the best first line treatment. Nasal abnormalities (eg, chronic sinusitis/rhinitis) were significant risk factors in children with milder SDB, suggesting that the evaluation and treatment of these abnormalities might be beneficial for this category of patients. Future research is indicated to confirm these findings, especially in children with moderate to severe SDB.