Sedation may alter laryngeal anatomy, function, and respiratory mechanics; therefore, it is essential that the practitioner has a thorough understanding of the pediatric airway. Physical examination reveals the general condition of a patient and the degree of the airway compromise. During sedation, adequate oxygenation and ventilation must be maintained despite a relative decrease in the rate and depth of respiration. Conditions that interfere with the integrity of the laryngeal inlet or upper larynx may impair effective ventilation as a result of partial or complete airway obstruction. Sleep-disordered breathing (SDB) is a spectrum of disorders ranging from primary snoring to obstructive sleep apnea syndrome (OSAS). When sedation without a secured airway is planned, it is imperative that the level of consciousness, adequacy of ventilation, and oxygenation be continuously monitored and the risk of apnea evaluated. When a child is sedated, the best prevention is to ensure that the position provides the best anatomical orientation for airway patency.