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Obstructive Sleep Apnea-Hypopnea Syndrome in Children With Down Syndrome Treated at a Tertiary Care Hospital in

Silvia N Suarez Mantilla1, Victor Manuel Mora Bautista1,2, Martha Lucia Africano Leon1,2

  • 1Pediatrics, Universidad Industrial de Santander, Bucaramanga, COL.

Cureus
|March 3, 2026
PubMed

Insights

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is common in children with Down syndrome (DS). This study found a lower-than-expected diagnosis rate, suggesting underdiagnosis due to access to polysomnography (PSG).

Area of Science:

  • Pediatrics
  • Sleep Medicine
  • Genetics

Background:

  • Obstructive sleep apnea-hypopnea syndrome (OSAHS) is prevalent in children with Down syndrome (DS), linked to anatomical factors like midfacial hypoplasia and macroglossia.
  • OSAHS is a significant cause of morbidity and mortality in children with DS, with untreated cases potentially leading to pulmonary hypertension.
  • Current guidelines recommend polysomnography (PSG) for all children with DS before age four due to the risks of untreated sleep-disordered breathing.

Purpose of the Study:

  • To examine the profile and frequency of OSAHS in children with Down syndrome.
  • To identify factors associated with OSAHS diagnosis in this population.
  • To highlight potential underdiagnosis and barriers to accessing diagnostic evaluations.

Main Methods:

  • A case-control study was conducted involving 124 patients with DS under 13 years of age.
  • Data were collected from patients treated at a tertiary care institution in northeastern Colombia between 2012 and 2023.
  • Diagnosis of OSAHS was based on polysomnography (PSG) findings.

Main Results:

  • Out of 124 patients with DS, 19 (15.3%) were diagnosed with OSAHS.
  • The only significant association found with OSAHS diagnosis was the place of residence, with urban dwellers having better access to PSG.
  • The observed frequency of OSAHS was lower than reported in previous literature, suggesting potential systematic underdiagnosis.

Conclusions:

  • Socioeconomic status and access to diagnostic evaluations, particularly PSG, appear to be primary determinants for OSAHS diagnosis in children with DS, rather than clinical characteristics.
  • The findings indicate a possible underdiagnosis of OSAHS in the DS population, especially in rural and low-income areas.
  • Expanding access to PSG and implementing universal screening protocols are crucial for early identification and management of OSAHS in children with Down syndrome.

Keywords:
colombiadown syndromeobstructive sleep apnea syndromepediatrics & child healthpolysomnographypolysomnography (psg)

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