Prevalence and predictors of obstructive sleep apnoea in young children with Down syndrome

Hill, Catherine M.; Evans, Hazel; Elphick, Heather; Farquhar, Michael; Pickering, Ruth; Kingshott, Ruth; Martin, Jane; Reynolds, Janine; Joyce, Anna; Rush, Carla; Gavlak, Johanna; Gringras, Paul

doi:10.1016/j.sleep.2016.10.001

Cited by 94 publications

(96 citation statements)

References 35 publications

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“…Children were recruited through multiple routes including via local neurodevelopmental paediatricians; specialist paediatricians within the Children’s hospitals and, finally, through advertising to local support groups, the UK Down Syndrome Association website and word of mouth between parents 23. This multiple method approach aimed to minimise selection bias.…”

Section: Methodsmentioning

confidence: 99%

“…OSA was assessed on a separate night using the SOMNOtouch device (Somnomedics, Germany) as previously described23 comprising: chest and abdominal respiratory inductance plethysmography; pulse oximetry; nasal pressure flow with snore sensor; body position sensor and actigraphy. A sleep log recorded sleep onset, night wakings and morning wake up times.…”

Section: Methodsmentioning

confidence: 99%

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Home oximetry to screen for obstructive sleep apnoea in Down syndrome

et al. 2018

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Home oximetry to screen for obstructive sleep apnoea in Down syndrome

et al. 2018

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“…Among six studies with 504 participants in Europe, the pooled OSA prevalence was 71.5% (95% CI: 61.1 to 80.9) [6], [24], [59], [61], [62], [67], [75]. 49.5 to 79.4).…”

Section: Prevalence Of Osa and Potential Moderatorsmentioning

confidence: 98%

“…Finally, one study used primarily in home PSG, with a small subgroup using in laboratory PSG; however, separate statistics were not provided for the laboratory PSG subgroup so this study was eliminated [61]. A final set of 10 studies were included that examined non-referred (e.g., who were not referred for a sleep study due to concern about sleep problems, upper airway obstruction, or other potentially comorbid problems) community samples of people with DS, containing 443 individuals [4]- [6], [59], [62]- [67].…”

Section: Included Studiesmentioning

confidence: 99%

Obstructive Sleep Apnea in Individuals with Down Syndrome: A Meta-Analytic Literature Review

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Nazir

et al. 2017

JSDR

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Abstract:Objective:Individuals diagnosed with Down syndrome (DS) are predisposed to obstructive sleep apnea (OSA). The aim of this study is to assess the prevalence of OSA and factors associated with OSA in this population. Study Design:Systematic literature review and meta-analysis. Methods:Studies of DS and OSA in the English language through May 2017 were reviewed. Since parental report of symptoms has limited validity related to the diagnosis of OSA, only studies using in laboratory polysomnography to diagnose OSA were included. Results:Twenty three studies examining OSA among 1,469 people with DS were found. Among ten studies using community referred samples, 71.5% of people with DS had OSA, compared to 69.6% in referred community samples suspected of having respiratory events. There was an inverse relationship between apnea hypopnea index (AHI) cutoffs and OSA prevalence as higher cutoffs were associated with somewhat lower prevalence.Examining age groups, adults had a higher prevalence of OSA (90.0%) compared to infants (66.5%) and children between 2-21 years of age (69.9%). Oxygen desaturation and gender did not affect prevalence.Although surgery had less effect on successfully treating OSA among DS individuals compared to those without DS in prior studies, lingual tonsillectomy had the greatest effect (mean AHI decrease of 9.0). Conclusion:OSA appears to occur frequently in children and adults with DS. Untreated, OSA may contribute to health problems and premature death, highlighting the potential importance of identifying OSA among people with DS.Even after traditional surgeries (i.e., adenotonsillectomy, tonsillectomy, adenoidectomy), repeating PSG is highly recommended as residual OSA can persist

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“…In comparison to other diseases associated with a high OSA prevalence in children, it is notable that the prevalence of OSA in children and adolescents with EDS was found to be even higher than in children and adolescents with e.g. cleft palate (8.5% with an oAHI ≥1) [22], but lower than in children with Pierre Robin syndrome (85% with a oAHI ≥1) or Down syndrome (73% with an oAHI ≥1) [23, 24]. In contrast to children suffering from these pathologies, in EDS patients craniofacial abnormalities are not risk factors for OSA [4].…”

Section: Discussionmentioning

confidence: 99%

Obstructive Sleep Apnoea in Children and Adolescents with Ehlers-Danlos Syndrome

et al. 2018

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Background: In Ehlers-Danlos syndrome (EDS), a group of monogenic disorders affecting connective tissues, obstructive sleep apnoea (OSA) is highly prevalent in adults. The prevalence of OSA in children with EDS is unknown. Objectives: This prospective cross-sectional study aimed at determining the prevalence of OSA in paediatric EDS patients. Methods: Children with EDS (n = 24) were recruited from the Children’s Hospital Zurich and matched to healthy controls. Participants completed home respiratory polygraphy and questionnaires (Sleep-Related Breathing Disorder Scale [SRBD], Epworth Sleepiness Scale [ESS], and Child Health Questionnaire [CHQ]). The American Academy of Sleep Medicine criteria were applied for OSA diagnosis (obstructive apnoea-hypopnoea index [oAHI] ≥1/h). Conditional logistic regression was used to compare the prevalence of OSA and to adjust for possible confounding. Results: OSA was found in 42% of paediatric EDS patients and in 13% of matched controls (OR = 4.5, 95% CI = 0.97–20.83, p = 0.054). The median oAHI was higher in EDS patients than in controls (0.77/h, IQR = 0.19–1.76, vs. 0.24/h, IQR = 0.0–0.60, p < 0.001 adjusted for age, sex, and BMI z-score). EDS patients had lower scores in most CHQ scales and higher SRBD and ESS scores than controls (0.26, IQR = 0.1–0.35, vs. 0.07, IQR = 0–0.19, p = 0.004); 7 ± 4 vs. 5 ± 4, p = 0.033, respectively). Conclusion: OSA is a previously underestimated EDS-related complication increasing disease burden.

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Prevalence and predictors of obstructive sleep apnoea in young children with Down syndrome

Cited by 94 publications

References 35 publications

Home oximetry to screen for obstructive sleep apnoea in Down syndrome

Home oximetry to screen for obstructive sleep apnoea in Down syndrome

Obstructive Sleep Apnea in Individuals with Down Syndrome: A Meta-Analytic Literature Review

Obstructive Sleep Apnoea in Children and Adolescents with Ehlers-Danlos Syndrome

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