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Published on: December 6, 2016
Prevalence of Obstructive Sleep Apnea in Children with Down Syndrome
Mieke Maris1, Stijn Verhulst2, Marek Wojciechowski2
1Department of Otorhinolaryngology, Head and Neck Surgery, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.
Insights
Obstructive sleep apnea (OSA) affects two-thirds of children with Down syndrome (DS). Parental reports of snoring or witnessed apneas indicate higher OSA prevalence and severity, with younger age linked to more severe disease.
Area of Science:
- Pediatric Pulmonology
- Genetics
- Sleep Medicine
Background:
- Down syndrome (DS) is associated with an increased risk of obstructive sleep apnea (OSA).
- Early identification and management of OSA are crucial for improving health outcomes in children with DS.
Purpose of the Study:
- To determine the prevalence of OSA in a large cohort of children with Down syndrome.
- To identify patient-related factors associated with OSA severity in this population.
Main Methods:
- Retrospective, cross-sectional study design.
- Full overnight polysomnography (PSG) was conducted.
- Data from 122 children with DS were analyzed.
Main Results:
- Overall OSA prevalence was 66.4% in children with DS.
- Severe OSA was diagnosed in nearly half of affected children.
- Parental reports of snoring or witnessed apneas correlated with higher OSA prevalence and severity (75.7% vs 53.8%, P=0.019).
- Younger age showed a significant inverse correlation with OSA severity (oAHI) (P=0.028).
- Sex and BMI z-score did not significantly correlate with OSA severity.
Conclusions:
- A high prevalence of OSA (66.4%) exists in children with Down syndrome, even in those without typical symptoms (53.8%).
- Parental observation of snoring or apneas is a key indicator for OSA risk.
- Younger age is a significant factor associated with more severe OSA in children with DS.
Study Objectives:
To evaluate the prevalence of obstructive sleep apnea (OSA) in a large cohort of children with Down syndrome (DS), and to investigate which patient- related factors correlate with disease severity.
Methods:
We performed a retrospective, cross-sectional study in children with DS referred for full overnight polysomnography in a tertiary care center.
Results:
Polysomnographic data are available for 122 children (70 boys), age 5.0 y (2.8-10.5), and body mass index (BMI) z-score 0.7 (-0.3 to 1.7). The overall prevalence of OSA was 66.4%. In almost half of these children severe OSA was diagnosed (obstructive AHI [oAHI] ≥ 10/h). In children with parental reports of snoring or witnessed apneas (group A), OSA was significantly more common (75.7%) than in those without these symptoms (group B) 53.8% (P = 0.019). Children in group A had more severe OSA, oAHI 5.7/h (1.7-13.8) compared to those in group B 2.2/h (0.8-8.0) (P = 0.018). A significant inverse correlation between age and oAHI (P = 0.028) was found. Sex and BMI z-score were not significantly correlated to oAHI.
Conclusions:
Based upon full night polysomnography, an overall 66.4% prevalence of OSA was found in children with Down syndrome. Even in those with a negative history for OSA, the prevalence was 53.8%. Younger age was associated with more severe disease.
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