Relationship between sleep, sleep apnea, and neuropsychological function in children with Down syndrome

Brooks, Lee J.; Olsen, Molly N.; Bacevice, Ann; Beebe, Andrea; Konstantinopoulou, Sofia; Taylor, H. Gerry

doi:10.1007/s11325-014-0992-y

Cited by 67 publications

(69 citation statements)

References 29 publications

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“…A cutoff AHI of ˂ 2/hr was utilized in most of these studies to define the absence of OSA, while 2.0-4.9/hr is often used to define mild OSA, 5.0-9.9 to define moderate OSA, and ˃10/hr to define severe OSA. Descriptively, across these child studies 21.5% of children had mild OSA (95% CI: 16.7 to 26.7), 20.3% moderate OSA (17.3 to 23.5), and 30.4% had severe OSA (20.5 to 41.2) [3], [6], [59], [62], [63], [65], [66], [68], [70], [76], [77]. All but two of these 11 child studies used an AHI cutoff of 2/hr for diagnosing OSA [11], [76].…”

Section: Prevalence Of Osa and Potential Moderatorsmentioning

confidence: 92%

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

Ridore

Debbarma

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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Section: Prevalence Of Osa and Potential Moderatorsmentioning

confidence: 92%

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

Ridore

Debbarma

Nazir

et al. 2017

JSDR

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“…Our results demonstrate that despite these children having significant improvements in OSA severity following surgery, approximately 50% have residual disease that is moderate/severe. from 16% to 66% 3,[12][13][14][15][16][17] ; these previous outcome data were based on relatively small cohorts of patients, ranging from 3 to 36 in sample size. Thottam and colleagues published the largest series to date, at 36 children, and they found that tonsillectomy (TO) decreased OSA severity, although only 16% of patients experienced complete resolution (OAHI < 1 event/h).…”

Section: Success Of Tonsillectomy For Obstructive Sleep Apnea In Chilmentioning

confidence: 99%

“…[1][2][3] Obstructive sleep apnea (OSA) is especially common in this population because of a combination of factors: macroglossia, hypotonia, increased prevalence of obesity, and craniofacial anatomy. Identification and treatment of OSA is important because it has been implicated as a contributing factor to pulmonary hypertension 1 as well as behavioral problems.…”

Section: Introductionmentioning

confidence: 99%

“…2 Successful treatment of OSA has been shown to improve measures of attention in children with DS. 3 Prevalence estimates of OSA in children with DS vary from 20% to 80%. [4][5][6][7] In 2011, the American Academy of Pediatrics (AAP) published clinical guidelines for children with DS recommending universal screening for OSA with a polysomnogram (PSG) by age 4 years even in asymptomatic children.…”

Section: Introductionmentioning

confidence: 99%

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Success of Tonsillectomy for Obstructive Sleep Apnea in Children With Down Syndrome

Ingram

Ruiz

Gao³

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: Obstructive sleep apnea (OSA) is common in children with Down syndrome (DS) and associated with significant morbidity. In the current study we examined polysomnographic outcomes of children with DS who underwent tonsillectomy. Methods: A retrospective chart review of children with DS who underwent a tonsillectomy between 2009-2015 was performed. All children had either a concurrent adenoidectomy or had previously underwent an adenoidectomy. Children with preoperative and postoperative polysomnograms within 6 months of surgery were included in the analysis. Preoperative OSA severity was categorized by obstructive apnea-hypopnea index (OAHI) as follows: mild = 1.5-4.9 events/h; moderate = 5-9.9 events/h; severe ≥ 10 events/h. Results: Seventy-five children with DS met inclusion criteria. The cohort included 41 males and 34 females with mean age of 5.1 years (± 3.6 years), range of 0.51-16.60 years. Preoperative OSA severity was as follows, mild = 8/75; moderate = 16/75; severe = 51/75. Cure rates varied depending on definition: 12% for OAHI < 1 event/h and 21% for OAHI < 2 events/h. 48% had residual OAHI < 5 events/h. On postoperative PSG 16/75 saw resolution (OAHI < 2) in OSA; mild = 21/75; moderate = 20/75; severe = 18/75. 48% moderate/severe patients saw conversion to mild or cure. Overall, tonsillectomy resulted in significant improvements in multiple respiratory parameters, including OAHI (OAHI; 21.3 ± 19.7 to 8.0 ± 8.1, P < .001), percent sleep time with oxygen saturations < 90% (19.0 ± 25.0 to 6.1 ± 10.1, P < .001), and percent sleep time with end-tidal carbon dioxide above 50 mmHg (7.7 ± 18.0 to 1.8 ± 6.6, P = .001). Average asleep oxygen saturation was associated with postoperative OSA severity. Conclusions: Children with DS and OSA who undergo tonsillectomy experience improvements in both respiratory event frequency and gas exchange but approximately half still have moderate to severe residual OSA. Keywords: child, Down syndrome, gas exchange, obstructive sleep apnea, polysomnography, tonsillectomy

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“…Врожденные пороки сердца и легочная гипоплазия, нередко наблюдаемые у детей с синдромом Дауна, могут дополнительно способствовать гипоксии в ночное время. Примечательно, что дети с синдромом Дауна, имеющие явные симптомы нарушений сна, характеризуются более выраженными психологическими отклонениями по срав-нению с теми, у которых нарушения сна выражены не сильно [33,34].…”

Section: вопросы современной педиатрииunclassified

Sleep Disorders in Mentally Retarded Children

Kelmanson

2014

Vopr. sovr. pediatr.

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Relationship between sleep, sleep apnea, and neuropsychological function in children with Down syndrome

Abstract: Although SDB is common in children with Down syndrome, it is not a major contributor to their cognitive deficits. Cognitive function is related to the amount of sleep and particularly slow wave sleep. Successful treatment of SDB may improve their attention.

Cited by 67 publications

References 29 publications

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

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

Success of Tonsillectomy for Obstructive Sleep Apnea in Children With Down Syndrome

Sleep Disorders in Mentally Retarded Children

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