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Demographic and Clinical Characteristics Associated With Adherence to Guideline-Based Polysomnography in Children

Philip D Knollman1,2, Christine H Heubi1,2,3, Susan Wiley4,5

  • 1Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 15, 2020
PubMed

Insights

About 60% of children with Down syndrome received polysomnography for obstructive sleep apnea screening. Factors like race and medical need influenced screening, highlighting a need for improved adherence to guidelines.

Area of Science:

  • Pediatric Medicine
  • Genetics
  • Sleep Medicine

Background:

  • Down syndrome is associated with a high prevalence of obstructive sleep apnea (OSA).
  • American Academy of Pediatrics guidelines recommend universal OSA screening for children with Down syndrome by age 4.
  • Adherence to these screening guidelines is crucial for early diagnosis and management of OSA in this population.

Purpose of the Study:

  • To compare demographic and clinical characteristics of children with Down syndrome who underwent polysomnography versus those who did not.
  • To assess factors influencing the uptake of recommended OSA screening in children with Down syndrome.

Main Methods:

  • Retrospective cohort study including 460 children with Down syndrome born between 2007 and 2012.
  • Comparison of children who received polysomnography with those who did not, analyzing demographic data, socioeconomic status, and comorbidities.
  • Statistical analysis to identify significant differences between the groups.

Main Results:

  • 273 (59.3%) children received at least one polysomnogram, with a median age of 3.6 years.
  • No significant differences in sex, insurance, or socioeconomic status between groups.
  • Significant differences observed in race distribution (P = .0004) and proximity to the medical center (P < .0001).
  • Hypothyroidism (P = .003) and pulmonary aspiration (P = .01) were associated with higher likelihood of polysomnography.

Conclusions:

  • Approximately 60% of children with Down syndrome received polysomnography, indicating suboptimal adherence to screening guidelines.
  • Factors such as race, proximity to the medical center, and increased medical need influenced screening rates.
  • Initiatives are needed to improve the proportion of children with Down syndrome receiving guideline-recommended OSA screening.
Abstract

Keywords:
Down syndromebirth cohortdisparitiesobstructive sleep apneapolysomnographysleep study

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