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Effect of body position and sleep state on obstructive sleep apnea severity in children with Down syndrome

Lauren C Nisbet1, Nicole N Phillips2, Timothy F Hoban3

  • 1The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|January 16, 2014
PubMed

Insights

Children with Down syndrome (DS) experience more severe obstructive sleep apnea (OSA) during non-rapid eye movement sleep, particularly when sleeping on their back. This highlights the importance of positional therapy for managing OSA in DS patients.

Area of Science:

  • Pediatric Sleep Medicine
  • Genetics and Sleep Disorders
  • Respiratory Physiology

Background:

  • Obstructive sleep apnea (OSA) is common in children with Down syndrome (DS).
  • Sleep position and state may influence OSA severity.
  • Understanding these factors is crucial for effective management in DS.

Purpose of the Study:

  • To investigate how sleep position and sleep state affect obstructive sleep apnea (OSA) severity in children with Down syndrome (DS).
  • To compare sleep and respiratory event patterns between children with DS and typically developing children.

Main Methods:

  • Retrospective review of polysomnography data from a tertiary sleep disorders laboratory.
  • Inclusion of children with DS and age/gender/AHI-matched typically developing controls.
  • Analysis of respiratory events (Apnea-Hypopnea Index - AHI) based on sleep state (NREM, REM) and position (supine, prone, lateral).

Main Results:

  • All children had higher AHIs during REM sleep compared to NREM sleep.
  • Children with DS had a significantly higher NREM AHI than controls, even when matched for overall OSA severity.
  • For children with DS, the NREM AHI was worse in the supine position compared to non-supine positions.

Conclusions:

  • While REM sleep contributes to respiratory events in all children, NREM sleep is a significant factor in OSA severity for children with DS.
  • The supine position exacerbates NREM sleep-related breathing issues in DS, potentially due to hypotonia.
  • These findings underscore the clinical relevance of NREM respiratory events and positional effects in DS, informing treatment strategies.
Abstract

Keywords:
Down syndromesleep position

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