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Prospective polysomnographic analysis of obstructive sleep apnea in down syndrome
Mark Eric Dyken1, Deborah C Lin-Dyken, Susan Poulton
1Roy J. and Lucille A. Carver College of Medicine, Department of Neurology Sleep Disorders Center, University of Iowa, Iowa City 52242, USA. mark-dyken@uiowa.edu
Insights
Obstructive sleep apnea (OSA) is highly prevalent in young individuals with Down syndrome, affecting 79%. Obesity and younger age were linked to lower oxygen levels during sleep, indicating a need for further research and improved therapies.
Area of Science:
- Pediatric Sleep Medicine
- Genetics and Developmental Disorders
Background:
- Down syndrome is frequently associated with craniofacial abnormalities that can predispose individuals to obstructive sleep apnea (OSA).
- Early identification and management of OSA are crucial for optimizing health outcomes in children with Down syndrome.
Purpose of the Study:
- To assess the prevalence of OSA in a nonselected pediatric population with Down syndrome.
- To investigate the relationship between OSA severity and clinical factors such as body mass index, age, and sleep quality.
Main Methods:
- Nineteen young patients (9 boys, 10 girls) with Down syndrome underwent standard overnight polysomnography.
- Apnea index, apnea-hypopnea index, and arterial oxygen saturation (SaO2) were analyzed.
Main Results:
- Obstructive sleep apnea (OSA) was diagnosed in 79% of the subjects based on pediatric standards.
- Higher body mass index correlated with increased apnea index and lower SaO2.
- Younger age and reported sleep symptoms were associated with lower SaO2 levels.
Conclusions:
- A high percentage of young individuals with Down syndrome exhibit OSA, underscoring the need for routine screening.
- Obesity, younger age, and poor sleep quality are associated with OSA severity in this population.
- Further research is warranted to refine diagnostic criteria and therapeutic strategies for OSA in Down syndrome.
Objectives:
To investigate obstructive sleep apnea (OSA) in a consecutively encountered, nonselected population of young patients with Down syndrome using standard overnight polysomnography and to determine the effects of therapy.
Methods:
In a population of patients seen for routine developmental evaluations, 9 boys and 10 girls were studied using standard overnight polysomnography.
Results:
Using pediatric standards, OSA was found in 79% of the subjects (95% confidence interval, 54%-94%), with a median apnea index of 3 events per hour (interquartile range, 2-5), a median apnea-hypopnea index of 6 events per hour (interquartile range, 3-8), and a median arterial oxygen saturation (SaO2) low point of 88% (interquartile range, 84%-90%). Higher body mass index was significantly associated with a higher apnea index and a lower SaO2 level, and there was a significant inverse relationship between age and the lowest SaO2 value as well as a possible association between sleep-related symptoms at the time of diagnosis and the lowest SaO2 value. In addition, patients with OSA had a significantly higher movement arousal index than those without OSA.
Conclusions:
Using rigid polysomnographic standards, this pilot study revealed OSA in a high percentage of young subjects with Down syndrome and an association between OSA and obesity, age, and poor sleep quality. These findings justify larger and more detailed population studies to further define clinical factors that are concomitant with OSA in Down syndrome and to improve therapy.