Abstract
Aim: Obstructive sleep apnea (OSA) is a complex and multifactorial condition in children with Down syndrome (DS) with prevalence rates between 30 and 60%. We aimed to investigate the prevalence of OSA in a large cohort of DS children and to investigate which patient related factors correlated with disease severity.
Methods: All children enrolled in our multidisciplinary Down team were referred for polysomnography (PSG) when there was a positive history for OSA (snoring, witnessed apneas) (group A) or as part of “good clinical practice” to screen for OSA in this high risk population (group B) (Shott et al. 2006). A diagnosis of OSA is established at an obstructive apnea/hypopnea index (oAHI) ≥ 2/hr. Values are presented as mean ± standard deviation.
Results: Polysomnographic data are available for 93 children: 48 boys and 45 girls, age 7.1 ± 5.1years, BMI 19. 2 ± 4.6 kg/m2. The prevalence of OSA was 66.7% with an oAHI 10.2 ±16.8/h, mean oxygen saturation 96,34 ± 1,38 % and minimum saturation 85,85 ± 9,98%. Moderately severe OSA (oAHI >5 and <10/h) was found in 22.5% and severe OSA (≥10/h) in 45.2%. OSA was significantly more common for group A (74,1%) compared to group B (54,1%) (p=0.048). Multiple linear regression analysis showed a significant relationship (p=0,001) between oAHI and BMI but not with age or sex.
Conclusions:
We found an overall 66.7% prevalence of OSA in children with Down syndrome and a significant correlation between OSA severity and BMI. Even with a negative history for OSA, the prevalence was 54,1%. This figure is much higher than in the normally developing paediatric population. Our data support the notion that PSG should be part of the routine care for children with Down syndrome.
- © 2014 ERS