Adherence to CPAP therapy in Down syndrome: the population-based DISCOVERY study

Area of Science:

• Sleep Medicine
• Genetics
• Public Health

Background:

• Individuals with Down syndrome (DS) exhibit a higher prevalence and severity of obstructive sleep apnea (OSA).
• Limited data exists on the efficacy and adherence of continuous positive airway pressure (CPAP) therapy in patients with DS.

Purpose of the Study:

• To compare patient characteristics and CPAP treatment outcomes for OSA in individuals with and without DS.
• To evaluate adherence and effectiveness of CPAP therapy in a DS population.

Main Methods:

• A population-based, longitudinal study (DISCOVERY cohort) in Sweden.
• Matched control group (5:1 ratio) using Swedish National Patient Registry and Prescribed Drug Registry data.
• Analysis of patient characteristics, OSA severity, and CPAP usage and adherence over approximately 1.3 years.

Main Results:

• Patients with DS had higher apnea-hypopnea index, Epworth Sleepiness Scale scores, and rates of prior tonsil surgery and thyroid hormone therapy.
• Despite more severe OSA, CPAP usage time, adherence (≥4 hours/night), and improvement in daytime sleepiness were comparable between DS and non-DS groups.
• No significant differences in nocturnal CPAP usage, adherence, or Epworth Sleepiness Scale score improvement were observed.

Conclusions:

• OSA severity is significantly higher in individuals with DS.
• CPAP treatment adherence and effectiveness in improving daytime sleepiness are similar for patients with and without DS.
• These findings underscore the critical need for OSA diagnosis and effective CPAP treatment in individuals with Down syndrome.