Obstructive sleep apnea: Should all children with Down syndrome be tested?
Sally R Shott1, Raouf Amin, Barbara Chini
1Department of Otolaryngology/Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA.
Archives of Otolaryngology--Head & Neck Surgery
|April 19, 2006
Summary
Obstructive sleep apnea syndrome is common in young children with Down syndrome, affecting up to 80%. Parental perception of sleep issues does not reliably predict these abnormalities, necessitating baseline polysomnography (PSG) for early diagnosis.
Area of Science:
- Pediatric Pulmonology
- Genetics
- Sleep Medicine
Background:
- Down syndrome is associated with an increased risk of upper airway obstruction.
- Obstructive sleep apnea syndrome (OSAS) can negatively impact development and health in children.
- Early identification and management of OSAS are crucial for improving outcomes in children with Down syndrome.
Purpose of the Study:
- To determine the incidence of OSAS in children aged 2 to 4 years with Down syndrome.
- To evaluate the accuracy of parental reporting in identifying sleep abnormalities in this population.
Main Methods:
- Prospective cohort study involving 56 children with Down syndrome undergoing overnight polysomnography (PSG).
- Parents completed questionnaires on perceived sleep patterns prior to PSG.
- PSG data analyzed for obstructive index, carbon dioxide levels, hypoxemia, and arousal index.
Main Results:
- High incidence of OSAS observed: 57% had abnormal PSG results for OSAS, rising to 80% when including elevated arousal index.
- Parental reports of sleep problems showed poor correlation with PSG findings; 54% of children with no reported issues had abnormal PSGs.
- Only 36% of parents who reported sleep problems had children with abnormal sleep study results.
Conclusions:
- A high prevalence of OSAS exists in young children with Down syndrome.
- Parental perception is an unreliable indicator of sleep abnormalities in this group.
- Baseline PSG screening for OSAS is recommended for all children with Down syndrome around ages 3 to 4 years.
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