TY - JOUR
T1 - Obstructive Sleep Apnea in Children with Down Syndrome
T2 - Demographic, Clinical, and Polysomnographic Features
AU - Chamseddin, Bahir H.
AU - Johnson, Romaine F.
AU - Mitchell, Ron B.
N1 - Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2018.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objectives: To evaluate demographic, clinical, and polysomnographic features of children with Down syndrome suspected of having obstructive sleep apnea. To identify factors that predict severe obstructive sleep apnea among children with Down syndrome. Study Design: Case series with chart review. Setting: Children’s Medical Center Dallas / University of Texas Southwestern Medical Center. Subject and Methods: Demographic, clinical, and polysomnographic data were collected for children with Down syndrome aged 2 to 18 years. Simple and multivariable regression models were used to study predictors of severe obstructive sleep apnea (apnea-hypopnea index ≥10). P≤.05 was considered significant. Results: A total of 106 children with Down syndrome were included, with 89 (84%) <12 years old, 56 (53%) male, 72 (68%) Hispanic, 15 (14%) African American, and 14 (13%) Caucasian. Ninety percent of children had ≥1 medical comorbidities; 95 (90%) patients had obstructive sleep apnea; and 46 (44%) had severe obstructive sleep apnea. The mean SaO 2 nadir was lower among obese than nonobese children (80% vs 85%, P =.02). Obese versus nonobese patients had a higher prevalence of severe obstructive sleep apnea (56% vs 35%, P =.03). Severe OSA was associated with heavier weight (odds ratio = 1.0, 95% CI: 1.0-1.1, P =.002) and age ≥12 years (odds ratio = 1.2, 95% CI: 0.2-2.5, P =.02). The multivariable model showed that severe obstructive sleep apnea was associated only with weight (odds ratio = 1.1, 95% CI: 1.0-1.1, P =.02). Conclusion: Obese children with DS are at a high risk for severe OSA, with weight as the sole risk factor. The results of this study show the importance of monitoring the weight of children with DS and counseling parents of children with DS about weight loss.
AB - Objectives: To evaluate demographic, clinical, and polysomnographic features of children with Down syndrome suspected of having obstructive sleep apnea. To identify factors that predict severe obstructive sleep apnea among children with Down syndrome. Study Design: Case series with chart review. Setting: Children’s Medical Center Dallas / University of Texas Southwestern Medical Center. Subject and Methods: Demographic, clinical, and polysomnographic data were collected for children with Down syndrome aged 2 to 18 years. Simple and multivariable regression models were used to study predictors of severe obstructive sleep apnea (apnea-hypopnea index ≥10). P≤.05 was considered significant. Results: A total of 106 children with Down syndrome were included, with 89 (84%) <12 years old, 56 (53%) male, 72 (68%) Hispanic, 15 (14%) African American, and 14 (13%) Caucasian. Ninety percent of children had ≥1 medical comorbidities; 95 (90%) patients had obstructive sleep apnea; and 46 (44%) had severe obstructive sleep apnea. The mean SaO 2 nadir was lower among obese than nonobese children (80% vs 85%, P =.02). Obese versus nonobese patients had a higher prevalence of severe obstructive sleep apnea (56% vs 35%, P =.03). Severe OSA was associated with heavier weight (odds ratio = 1.0, 95% CI: 1.0-1.1, P =.002) and age ≥12 years (odds ratio = 1.2, 95% CI: 0.2-2.5, P =.02). The multivariable model showed that severe obstructive sleep apnea was associated only with weight (odds ratio = 1.1, 95% CI: 1.0-1.1, P =.02). Conclusion: Obese children with DS are at a high risk for severe OSA, with weight as the sole risk factor. The results of this study show the importance of monitoring the weight of children with DS and counseling parents of children with DS about weight loss.
KW - Down syndrome
KW - obesity
KW - obstructive sleep apnea
KW - pediatrics
KW - polysomnography
UR - http://www.scopus.com/inward/record.url?scp=85053370162&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053370162&partnerID=8YFLogxK
U2 - 10.1177/0194599818797308
DO - 10.1177/0194599818797308
M3 - Review article
C2 - 30149781
AN - SCOPUS:85053370162
SN - 0194-5998
VL - 160
SP - 150
EP - 157
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 1
ER -