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Obstructive sleep apnea in children with Down syndrome.
C L Marcus1, T G Keens, D B Bautista
1Division of Neonatology and Pediatric Pulmonology, Childrens Hospital of Los Angeles, CA 90027.
Pediatrics
|July 1, 1991
Summary
Children with Down syndrome often have obstructive sleep apnea syndrome (OSAS), including obstructive sleep apnea (OSA), hypoxemia, and hypoventilation. OSAS is frequently present even when not clinically suspected, impacting their health.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Genetics
Background:
- Children with Down syndrome have predisposing factors for obstructive sleep apnea syndrome (OSAS).
- The specific type and severity of OSAS in this population have not been well-characterized.
- OSAS may contribute to unexplained pulmonary hypertension in Down syndrome.
Purpose of the Study:
- To characterize the type and severity of obstructive sleep apnea syndrome (OSAS) in children with Down syndrome.
- To compare nap polysomnography with overnight polysomnography for diagnosing OSAS in this cohort.
- To investigate the clinical suspicion of OSAS versus polysomnographic findings.
Main Methods:
- Fifty-three children with Down syndrome underwent polysomnography (nap or overnight).
- Measurements included chest wall movement, heart rate, electrooculogram, and blood gases (PO2, PCO2).
- Overnight polysomnography was performed on 16 subjects.
Main Results:
- Nap polysomnograms were abnormal in 77% of children; overnight studies were abnormal in 100%.
- Obstructive sleep apnea (OSA), hypoventilation, and desaturation were common findings.
- Nap studies underestimated OSAS prevalence compared to overnight studies.
Conclusions:
- Children with Down syndrome frequently have OSAS, characterized by OSA, hypoxemia, and hypoventilation.
- OSAS is often present in children with Down syndrome without clinical suspicion.
- Tonsillectomy and adenoidectomy showed some improvement but did not fully normalize polysomnograms in most cases.