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Co-Occurring Conditions and Sleep Symptoms Associated With Obstructive Sleep Apnea in Children With Down Syndrome
Taylor A Curry1, Emily Cooper2, John Brinton2,3
1Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Pediatric Pulmonology
|November 25, 2025
Summary
Sleep disordered breathing (SDB) is common in children with Down syndrome (DS). Witnessed apnea and higher BMI are linked to more severe obstructive sleep apnea (OSA) in this population.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Genetics
Background:
- Sleep disordered breathing (SDB) is highly prevalent in children with Down syndrome (DS).
- The American Academy of Pediatrics recommends routine polysomnography for children with DS aged 3-4 years.
- Understanding SDB patterns in DS is crucial for early intervention.
Purpose of the Study:
- To characterize clinical symptoms and breathing patterns in children with DS using polysomnogram data.
- To identify factors associated with obstructive sleep apnea (OSA) severity in this cohort.
Main Methods:
- Retrospective analysis of polysomnogram data from 526 children with DS at moderate altitude.
- Primary outcome: obstructive apnea hypopnea index (OAHI).
- Secondary outcomes: central apnea index (CAI), gas exchange, sleep symptoms, and comorbidities; explored associations with OSA severity.
Main Results:
- 79.7% of children with DS were diagnosed with OSA (OAHI ≥ 2 events/h); 51.0% had moderate/severe OSA.
- Witnessed apnea correlated positively with moderate/severe OSA.
- Higher BMI category was significantly associated with more severe OSA (p=0.02).
- Restless sleep and feeding difficulties showed negative associations with OSA severity.
Conclusions:
- A high prevalence of OSA is confirmed in children with Down syndrome.
- Caregiver-reported witnessed apneic events and BMI category are associated with increased OSA severity.
- These findings highlight the importance of monitoring SDB in children with DS.
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