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Central breathing abnormalities in children with trisomy 21: Effect of age, sex, and concomitant OSA

Samira Naime1, Miriam Weiss1, Jenny Lew1

  • 1Division of Pediatric Pulmonary and Sleep Medicine, Children's National Hospital, George Washington University, Washington, District of Columbia, USA.

Pediatric Pulmonology
|November 4, 2020
PubMed

Insights

Central breathing abnormalities are common in children with Trisomy 21 (TS21), particularly in those under two years old and in females over two. These conditions often coexist with obstructive sleep apnea and hypoxemia.

Area of Science:

  • Pediatric Sleep Medicine
  • Genetics and Rare Diseases
  • Respiratory Medicine

Background:

  • Trisomy 21 (TS21) presents a significant risk for sleep apnea in pediatric populations.
  • Central breathing disorders are a notable concern in children with TS21.
  • Understanding these sleep-related breathing issues is crucial for managing TS21.

Purpose of the Study:

  • To characterize the clinical and polysomnographic features of central apnea in infants, children, and adolescents with TS21.
  • To identify age- and sex-related patterns in central breathing abnormalities in TS21.
  • To assess the co-occurrence of central apnea with other sleep-disordered breathing in TS21.

Main Methods:

  • Retrospective analysis of baseline polysomnograms (PSGs).
  • Study included 158 pediatric patients (0-18 years) diagnosed with TS21.
  • Data collected from a specialized sleep center.

Main Results:

  • 12% of pediatric TS21 subjects exhibited a central apnea index (CAI) > 2/h.
  • Central breathing abnormalities were more prevalent in younger children (≤2 years) and decreased with age.
  • Females with TS21 showed a higher persistence of central breathing abnormalities beyond early childhood compared to males.
  • Obstructive sleep apnea (OSA) and/or hypoxemia frequently accompanied central apnea in TS21 patients.

Conclusions:

  • Central breathing abnormalities are prevalent in young children with TS21 and persist longer in females over two years of age.
  • Central apnea in TS21 often occurs alongside obstructive sleep apnea and/or hypoxemia.
  • These findings highlight the need for comprehensive sleep evaluations in children with TS21.
Abstract

Keywords:
Down syndromecentral apneaobstructive sleep apneatrisomy 21

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