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Published on: December 6, 2016
Obstructive Sleep Apnea in Children with Down Syndrome: Demographic, Clinical, and Polysomnographic Features
Bahir H Chamseddin1, Romaine F Johnson1,2, Ron B Mitchell1,2
11 University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Insights
Obese children with Down syndrome (DS) have a high risk for severe obstructive sleep apnea (OSA), with weight being the primary predictor. Monitoring weight and counseling on weight loss are crucial for managing OSA in this population.
Area of Science:
- Pediatric Pulmonology
- Genetics
- Sleep Medicine
Background:
- Down syndrome (DS) is associated with an increased risk of medical comorbidities, including obstructive sleep apnea (OSA).
- Identifying predictors of severe OSA in children with DS is crucial for timely intervention and management.
Purpose of the Study:
- To evaluate demographic, clinical, and polysomnographic features in children with DS suspected of having OSA.
- To identify factors that predict severe OSA among children with DS.
Main Methods:
- A case series with chart review was conducted.
- Demographic, clinical, and polysomnographic data were collected for 106 children with DS (aged 2-18 years).
- Regression models were used to identify predictors of severe OSA (apnea-hypopnea index ≥10).
Main Results:
- 90% of children had OSA, and 44% had severe OSA.
- Obese children had a lower mean SaO2 nadir and a higher prevalence of severe OSA compared to nonobese children.
- Severe OSA was significantly associated with weight (odds ratio = 1.1, P = .02) in multivariable analysis.
Conclusions:
- Obesity is a significant risk factor for severe OSA in children with Down syndrome.
- Weight is the sole identified predictor of severe OSA in this population.
- Monitoring weight and providing weight management counseling are essential for children with DS.
Objectives:
To evaluate demographic, clinical, and polysomnographic features of children with Down syndrome suspected of having obstructive sleep apnea. To identify factors that predict severe obstructive sleep apnea among children with Down syndrome.
Study Design:
Case series with chart review.
Setting:
Children's Medical Center Dallas / University of Texas Southwestern Medical Center.
Subject And Methods:
Demographic, clinical, and polysomnographic data were collected for children with Down syndrome aged 2 to 18 years. Simple and multivariable regression models were used to study predictors of severe obstructive sleep apnea (apnea-hypopnea index ≥10). P≤ .05 was considered significant.
Results:
A total of 106 children with Down syndrome were included, with 89 (84%) <12 years old, 56 (53%) male, 72 (68%) Hispanic, 15 (14%) African American, and 14 (13%) Caucasian. Ninety percent of children had ≥1 medical comorbidities; 95 (90%) patients had obstructive sleep apnea; and 46 (44%) had severe obstructive sleep apnea. The mean SaO2 nadir was lower among obese than nonobese children (80% vs 85%, P = .02). Obese versus nonobese patients had a higher prevalence of severe obstructive sleep apnea (56% vs 35%, P = .03). Severe OSA was associated with heavier weight (odds ratio = 1.0, 95% CI: 1.0-1.1, P = .002) and age ≥12 years (odds ratio = 1.2, 95% CI: 0.2-2.5, P = .02). The multivariable model showed that severe obstructive sleep apnea was associated only with weight (odds ratio = 1.1, 95% CI: 1.0-1.1, P = .02).
Conclusion:
Obese children with DS are at a high risk for severe OSA, with weight as the sole risk factor. The results of this study show the importance of monitoring the weight of children with DS and counseling parents of children with DS about weight loss.
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