Sleep-disordered breathing (SDB) is one of the most common comorbidities in children with Prader-Willi Syndrome (PWS). In the first years of life, these patients are mostly affected by central apneas (CA), while in older children sleep apnea syndrome (OSAS) gradually appeared linked to obesity, craniofacial conformation, hypotonia and scoliosis. Therapy for these patients is often debated and watchful waiting is also contemplated as a possible strategy. However, there is a lack of data on the long-term progression of OSAS in patients with PWS that can help us determine an appropriate management strategy.