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Prevalence of Obstructive Sleep Apnea in Children With Down Syndrome: A Meta-Analysis

Chia-Fan Lee1, Chia-Hsuan Lee2,3, Wan-Yi Hsueh4,5,6

  • 1Speech Language Pathologist, Child Developmental Assessment and Intervention Center, Taipei City Hospital, Taipei, Taiwan.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|May 9, 2018
PubMed

Insights

Obstructive sleep apnea (OSA) is very common in children with Down syndrome. Moderate to severe OSA prevalence is higher in younger children, with polysomnography showing higher rates than polygraphy.

Area of Science:

  • Pediatric Pulmonology
  • Genetics and Rare Diseases
  • Sleep Medicine

Background:

  • Down syndrome (Trisomy 21) is associated with an increased risk of various health complications.
  • Obstructive sleep apnea (OSA) is a significant concern in the pediatric population, particularly in those with genetic syndromes.
  • Understanding the prevalence of OSA in children with Down syndrome is crucial for timely diagnosis and management.

Purpose of the Study:

  • To estimate the overall prevalence of obstructive sleep apnea (OSA) in children with Down syndrome.
  • To analyze the prevalence of OSA based on different apnea-hypopnea index (AHI) thresholds.
  • To compare OSA prevalence between polysomnography and polygraphy sleep studies.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed, MEDLINE, EMBASE, Cochrane).
  • Keywords included "Down syndrome," "Trisomy 21," "OSA," "sleep apnea syndromes," "polysomnography," and "polygraphy."
  • A random-effects model was used to estimate OSA prevalence, with subgroup analyses and meta-regression performed.

Main Results:

  • Eighteen studies comprising 1,200 children with Down syndrome were included.
  • For polysomnography, OSA prevalence (AHI > 1, 1.5, 2, 5, 10 events/h) ranged from 34% to 76%.
  • OSA prevalence (AHI > 1.5) was lower with polygraphy (59%) compared to polysomnography (76%); higher prevalence of moderate to severe OSA was noted in younger children.

Conclusions:

  • Obstructive sleep apnea is highly prevalent in children with Down syndrome.
  • The prevalence of moderate to severe OSA appears to be higher in younger children.
  • Polysomnography indicates a higher prevalence of OSA compared to polygraphy in this population.
Abstract

Keywords:
Down syndromechildpolysomnographyprevalencesleep apnea syndromes

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