Related Experiment Video
Updated: Jan 5, 2026
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Outcomes in children with down syndrome and mild obstructive sleep apnea treated non-surgically
Javier J M Howard1, Kathleen M Sarber2,3, Wenwen Yu2,4
1College of Medicine, University of Cincinnati, Cincinnati, Ohio, U.S.A.
Insights
Single medication or oxygen therapy showed low effectiveness for mild obstructive sleep apnea (OSA) in children with Down syndrome (DS). Multimodality treatments may be necessary for this population.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Genetics
Background:
- Mild obstructive sleep apnea (OSA) is common in children with Down syndrome (DS).
- Standard treatments like nasal steroids, oral anti-leukotrienes, and oxygen are effective in healthy children but their efficacy in DS is unknown.
- Non-surgical interventions are crucial for managing OSA in this vulnerable population.
Purpose of the Study:
- To evaluate the effectiveness of single medication therapy, supplemental oxygen, or observation for mild OSA in children with Down syndrome.
- To compare polysomnographic outcomes between different non-surgical treatment groups.
- To determine the resolution rate of mild OSA in children with DS under these treatments.
Main Methods:
- Retrospective review of children (<18 years) with DS and mild OSA (obstructive apnea-hypopnea index [oAHI] ≥1 to <5 events/hour) treated non-surgically from 2012-2017.
- Analysis of demographic data, comorbidities, and pre- and post-treatment polysomnograms.
- Assessment of oAHI, oxyhemoglobin saturation nadir, and % total sleep time in REM.
Main Results:
- No significant changes in oAHI, oxygen saturation, or CO2 levels were observed across treatment groups (medication, oxygen, observation).
- OSA resolution rates were low: 20% with medication, 7.7% with observation, and 0% with oxygen.
- Treatment outcomes did not correlate with reported symptoms or baseline OSA severity.
Conclusions:
- Single-agent therapies demonstrate limited efficacy in resolving mild OSA in children with Down syndrome.
- Multimodality treatment approaches should be considered for managing mild OSA in this population.
- Further prospective studies are needed to establish effective treatment strategies for children with DS and OSA.
Objectives:
Nasal steroids, oral anti-leukotrienes and supplemental oxygen are effective in the treatment of mild obstructive sleep apnea (OSA) in otherwise healthy children. However, their efficacy is unknown in children with Down syndrome (DS). Here we examine the effect of single medication therapy versus observation versus oxygen on polysomnographic outcomes in these children.
Methods:
We reviewed children (<18 years) diagnosed with DS and mild OSA (obstructive apnea-hypopnea index [oAHI] ≥1 to <5 events/hour) treated non-surgically (with supplemental oxygen, one medication, or observation) between 2012 and 2017. Demographic data, comorbid diagnoses, and pre- and posttreatment polysomnograms were analyzed. We assessed pre- and posttreatment oAHI, oxyhemoglobin saturation nadir, percent total sleep time (%TST) in rapid eye movement (REM), and end-tidal carbon dioxide (ETCO2 ) >50 mmHg.
Results:
Twenty-four children met inclusion criteria; 10 treated with medication, one with oxygen, and 13 with observation (baseline oAHI was 3.5, 3.3, and 2.9 events/hour, respectively). There was no significant change in oAHI, oxyhemoglobin saturation nadir, ETCO2 , or percent TST in REM after treatment for any treatment group (P = .21-.94). There was no association between reported symptoms and AHI severity or change in AHI. OSA resolved in one patient treated with observation and two treated with medication, but worsened in two each in the medication and observation groups. Resolution of OSA occurred in 20% treated with medication, 7.7% with observation, and 0% with oxygen (P = .82).
Conclusion:
In our cohort, resolution of mild OSA was low. This suggests that consideration should be given to multimodality treatments in children with DS and mild OSA. Prospective studies will help establish effectiveness in this cohort.
Level Of Evidence:
4 Laryngoscope, 130:1828-1835, 2020.
More Related Videos
Related Concept Videos
01:21Sleep Apnea
The condition is more prevalent among...
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:26COPD: Management Using Bronchodilators and Corticosteroids