Predictors of sleep disordered breathing in children with Down syndrome: a systematic review and meta-analysis

Area of Science:

• Pediatrics
• Genetics
• Sleep Medicine

Background:

• Children with Down syndrome exhibit an elevated risk for sleep disordered breathing (SDB).
• SDB in this population is linked to severe health issues, including neurocognitive deficits, cardiometabolic conditions, and systemic inflammation.
• Identifying predictive clinical markers for SDB is essential for timely intervention and morbidity prevention.

Purpose of the Study:

• To systematically review and identify predictors of SDB in children diagnosed with Down syndrome.
• To synthesize current evidence on clinical markers associated with SDB in this specific pediatric cohort.

Main Methods:

• A comprehensive literature search was conducted across major databases: MEDLINE, Embase, Cochrane Central Register, and CINAHL.
• A meta-analysis was performed following the Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines.
• The review analyzed associations between various variables and SDB in children with Down syndrome, assessing evidence quality.

Main Results:

• The systematic review found inconsistent associations between potential predictors and SDB in children with Down syndrome, with evidence quality being generally poor.
• Meta-analysis indicated that children diagnosed with obstructive sleep apnea (OSA) were older than their non-OSA counterparts.
• The risk of OSA was found to be similar between males and females, with a slight trend favoring males.

Conclusions:

• The findings support current recommendations for routine polysomnography screening for children with Down syndrome by age four.
• The meta-analysis highlights the necessity for ongoing, longitudinal screening to detect SDB development as children age.
• Further research with higher quality evidence is needed to establish reliable predictors for SDB in children with Down syndrome.