Severity of obstructive apnoea in children with Down syndrome who snore

Diagnostic overnight polysomnograms of 33 children with Down syndrome who snored were reviewed. Mean age was 4.9 years, none had had adenotonsillectomy, 91% were non-obese (Down syndrome specific body mass index standard deviation score (BMI SDS) <+2.0) and yet 97% demonstrated obstructive sleep apnoea, with an average apnoea hypopnoea index (AHI) of 12.9 episodes per hour (normal <1) and an average oxygen desaturation of 4%. A higher AHI was associated with lower minimum Spo2, higher Tcco2 and higher number of arousals from sleep per hour (p<0.001). Polysomnography should be a routine investigation for children with Down syndrome who snore regardless of body habitus.