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Updated: Aug 2, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Developmental changes in obstructive sleep apnea and sleep architecture in Down syndrome

Ryan Kahanowitch1, Hector Aguilar1, Miriam Weiss1

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

Pediatric Pulmonology
|April 14, 2023
PubMed

Insights

Children with Down syndrome (DS) have significantly higher rates of severe obstructive sleep apnea (OSA), particularly in young children and adolescents. Sleep architecture in DS is also affected, with longer REM sleep onset and increased arousals.

Area of Science:

  • Pediatric Sleep Medicine
  • Neurodevelopmental Disorders
  • Genetics

Background:

  • Down syndrome (DS), or Trisomy 21, is linked to neurodevelopmental abnormalities and increased risk of sleep apnea.
  • Understanding age-related sleep differences in DS is crucial for early intervention.

Purpose of the Study:

  • To characterize age-related differences in sleep architecture and obstructive sleep apnea (OSA) severity in children with DS compared to euploid children.
  • To identify specific sleep disturbances associated with DS across different age groups.

Main Methods:

  • Retrospective analysis of polysomnograms from 4151 children (0-18 years), including 218 with DS.
  • Comparison of sleep parameters between DS and euploid individuals.

Main Results:

  • Severe OSA was more prevalent in the DS group (34%) versus euploid (18%), with peaks in children under 3 and over 10 years.
  • Children with DS exhibited prolonged REM sleep onset latency and higher arousal indexes.
  • These differences persisted after adjusting for age, sex, and BMI.

Conclusions:

  • Severe OSA in children with DS follows a U-shaped age distribution, peaking in infancy and adolescence.
  • DS is associated with altered sleep architecture, including longer REM latency and elevated arousals.
  • These findings provide critical insights for managing sleep and neurodevelopment in children with DS.
Abstract

Keywords:
Down syndromeREMTrisomy 21obstructive sleep apnea

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