The Timecourse of obstructive sleep apnoea in children with Down syndrome

Abstract

Introduction: Children with Down syndrome have high rates for the incidence and recurrence of obstructive sleep apnoea (OSA), due to their anatomical and neuromuscular abnormalities. This retrospective study describes the evolution of OSA on PSG measurements over time in a large cohort of children with Down syndrome, who attended two tertiary sleep centres in Australia. Methods: Children were selected for this study if they were diagnosed with Down syndrome and underwent formal polysomnography (PSG) in one of two tertiary Pediatric Hospital Sleep Units over a selected 3.5 year period. Once subjects were identified, all sleep study and treatment records were retrieved for the lifetime of the child, through 2018. Results: Records of 154 children with Down syndrome were reviewed between two centres, with 90 (58.4%) males, average age at the time of first study was 5.0 ± 4.3 years. The mean number of studies evaluated per patient was 3.4 ± 3.1. Cardiac disease was present in 86 (57.7%) and 3 (2.0%) had died at the time of this review. We included 37 infants (age < 1 year), who tended to have more severe disease with mean total AHI 32.4 ± 31.9 and OAHI 20.5 ± 23.3/hr and was associated with failure to thrive in 4 (10.8%). For those >2 years of age, overall mean AHI was 13.8 ± 23.4 and OAHI 11.2 ± 22.9 with 19 (18.8%) obese. Children with normal initial studies were more likely to have only one study. Amongst 84 (56.4%) children who had ≥2 studies, 72 (80.9%) had moderate or severe disease at some point. Discussion: Children with Down syndrome may have severe upper-airway obstruction in infancy, and monitoring for OSA needs to continue over time as the majority of children monitored over time had moderate or severe disease at some timepoint.L6342517742021-03-02 <br />