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Summary: Paediatric obstructive sleep disordered breathing (OSDB) has a considerable impact on cardiovascular physiology, but the consequences on children's basal metabolism and response to exercise are far from being known. The objective was to propose model estimations for paediatric OSDB metabolism at rest and during exercise. A retrospective case–control analysis of data from children submitted to otorhinolaryngology surgery was performed. The heart rate (HR) was measured, while oxygen consumption (VO2) and energy expenditure (EE) at rest and during exercise were obtained using predictive equations. The results for the patients with OSDB were compared with controls. A total of 1256 children were included. A total of 449 (35.7%) had OSDB. The patients with OSDB showed a significantly higher resting heart rate (94.55 ± 15.061 bpm in OSDB vs. 92.41 ± 15.332 bpm in no‐OSDB, p = 0.041). The children with OSDB showed a higher VO2 at rest (13.49 ± 6.02 mL min−1kg−1 in OSDB vs. 11.55 ± 6.83 mL min−1kg−1 in no‐OSDB, p = 0.004) and a higher EE at rest (67.5 ± 30.10 cal min−1kg−1 in OSDB vs. 57.8 + 34.15 cal min−1kg−1 in no‐OSDB, p = 0.004). At maximal exercise, patients with OSDB showed a lower VO2max (33.25 ± 5.82 mL min−1kg−1 in OSDB vs. 34.28 ± 6.71 in no‐OSDB, p = 0.008) and a lower EE (166.3 ± 29.11 cal min−1kg−1 in OSDB vs. 171.4 ± 33.53 cal min−1kg−1 in no‐OSDB, p = 0.008). The VO2/EE increment with exercise (Δ VO2 and Δ EE) was lower in OSDB for all exercise intensities (p = 0.009). This model unveils the effect of paediatric OSDB on resting and exercise metabolism. Our findings support the higher basal metabolic rates, poorer fitness performance, and cardiovascular impairment found in children with OSDB. [ABSTRACT FROM AUTHOR]