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Dysphagia severity is associated with worse sleep-disordered breathing in infants with Down syndrome

Yeilim Cho1, Younghoon Kwon2, Lourdes DelRosso3

  • 1Sleep Center, University of Washington, Seattle, Washington.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|January 30, 2023
PubMed

Insights

Infants with Down syndrome (I-DS) often have dysphagia, which is linked to more severe obstructive sleep apnea. Early screening for both conditions in I-DS is recommended.

Area of Science:

  • Pediatric Medicine
  • Neurology
  • Sleep Medicine

Background:

  • Infants with Down syndrome (I-DS) frequently experience hypotonia, leading to muscle weakness.
  • This muscle weakness increases the risk of dysphagia (swallowing difficulties) and sleep-disordered breathing (SDB).
  • Limited data exists on the prevalence and severity of dysphagia and SDB in I-DS.

Purpose of the Study:

  • To determine the frequency and severity of dysphagia in infants with Down syndrome.
  • To investigate the relationship between dysphagia severity and polysomnography parameters in I-DS.
  • To assess the association between dysphagia and sleep-disordered breathing in this population.

Main Methods:

  • Retrospective analysis of 40 infants with Down syndrome (I-DS) who underwent polysomnography.
  • Data collected included clinical suspicion of dysphagia, feeding tube dependence, and polysomnographic findings.
  • Dysphagia was confirmed via video fluoroscopic swallow study when clinically suspected.

Main Results:

  • A significant proportion of I-DS exhibited dysphagia (13) or required a feeding tube (16).
  • Infants with feeding tubes had more severe obstructive sleep apnea (OSA) compared to those with low dysphagia suspicion (AHI 49.3 vs 19.2).
  • Dysphagia severity positively correlated with the severity of obstructive apnea-hypopnea index (r = .43, P = .006).

Conclusions:

  • There is a high incidence of dysphagia and sleep-disordered breathing in infants with Down syndrome.
  • The severity of dysphagia is directly associated with the severity of obstructive sleep apnea.
  • Early evaluation for both SDB and dysphagia is crucial for I-DS.
Abstract

Keywords:
Down syndromedysphagiainfantsobstructive sleep apneasleep-disordered breathing

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