The spectrum of obstructive sleep apnea in infants and children with Down Syndrome

Waters, Karen A.; Castro, Chenda; Chawla, Jasneek

doi:10.1016/j.ijporl.2019.109763

Cited by 28 publications

(26 citation statements)

References 31 publications

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“…Prior studies have reported relevant data on the clinical characteristics of sleep apnea in TS21 in children 12–17 . The most common sleep breathing disorder reported in TS21 is OSA, which is estimated to affect 30%–82.6% of the TS21 population 12–17 .…”

Section: Discussionmentioning

confidence: 99%

Central breathing abnormalities in children with trisomy 21: Effect of age, sex, and concomitant OSA

Naime

Weiss

Lew

et al. 2020

Pediatric Pulmonology

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Background: Trisomy 21 (TS21) is a condition with a high risk for sleep apnea. In the pediatric population, the risk also includes central breathing disorders. The aim of this study was to define the clinical and polysomnographic characteristics of central apnea in infants, children, and adolescents with TS21. Methods: Retrospective review of baseline polysomnograms (PSGs) in children with TS21 in the sleep center at Children's National Medical Center in Washington DC. Results: We included a total of 158 infants, children, and adolescents (0-18 years) with TS21 in this study. The median age was 4.82 years and 62% were male. The primary findings of the study are that (1) 12% of all pediatric subjects with TS21 included had a central apnea index (CAI) > 2/h; (2) the proportion of TS21 individuals with central breathing abnormalities progressively decreased with age being common in young individuals (≤2 years of age) but rare after 10 years of age; (3) additional sleep breathing disturbances (e.g., OSA and/or hypoxemia) are often present in children with TS21 and central apnea; and (4) the prevalence of central breathing abnormalities in TS21 is influenced by sex, being more likely to persist beyond early childhood (>2 years of age) in females than in males. Conclusion: Central breathing abnormalities are common in TS21 among young children (≤2 years of age) and in females older than 2 years of age. Central apnea is often associated with concomitant obstructive sleep apnea and/or hypoxemia in children with TS21.

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Section: Discussionmentioning

confidence: 99%

Central breathing abnormalities in children with trisomy 21: Effect of age, sex, and concomitant OSA

Naime

Weiss

Lew

et al. 2020

Pediatric Pulmonology

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“…52 Continuous positive airway pressure therapy is often attempted for the management of persisting OSA and is sustained in approximately 60% in the home. 53 Additional surgical procedures, including uvulopalatopharyngoplasty, lingual tonsillectomy, supraglottoplasty, partial midline glossectomy, and tongue suspension with or without lingual tonsillectomy have been suggested as surgical options, but there is currently limited evidence to support the routine use of these procedures. 54 Therefore, with the treatment options currently available, a significant number of children with DS may have residual sleep-disordered breathing and for this reason research study design will need to include evaluation of response to therapy for the specific sleep problem in order to accurately evaluate the effect on other outcomes.…”

Section: Discussionmentioning

confidence: 99%

The impact of sleep problems on functional and cognitive outcomes in children with Down syndrome: a review of the literature

Chawla

Burgess

Heussler

2020

Journal of Clinical Sleep Medicine

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The aim of this review was to summarize the existing literature on the association between sleep problems and cognition, function, and behavior in children with Down syndrome. Methods: Embase, PubMed, CINAHL, and PsychINFO databases were searched to retrieve all studies published between 1990 and 2018 that evaluated the relationship between sleep and cognition, function, or behavior in children with Down syndrome. Results: Fifteen articles were included, which were mostly of a cohort or case-controlled design. Five articles addressed sleep and cognition only, 6 reported on sleep and behavior, and only 1 reported on sleep and functional ability. Three papers evaluated sleep and both cognition and behavior. Findings varied across studies with methodological differences, making it difficult to directly compare results. The association between sleep and behavior or cognition in children with Down syndrome remains uncertain, but a large study in 110 children provides strong evidence of a negative impact of sleep disorders on the accomplishment of daily life habits. Conclusions: The impact of coexisting sleep disorders in children with Down syndrome has not been widely studied, with only 15 relevant studies found through an extensive literature review. Large well-designed studies are required to fully understand this relationship further. This is important as sleep-disordered breathing and difficulties with sleep patterns and routines are highly prevalent in children with Down syndrome. Sleep may be one of the few treatable factors that can assist in improving long-term outcomes in this population.

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“…However, the heterogeneity between the studies in terms of the method used for the diagnosis of the respiratory disorder is noteworthy: polysomnography (PSG), home polysomnography (HPSG), home night sleep records, cardiorespiratory polygraphy, housekeeping, McGill oximetry score, and actigraphy. In some cases, only questionnaires or scales were used, such as: Pittsburgh Sleep Quality Index (PSQI); Epworth Sleepiness Scale (ESS); Berlin Questionnaire (BQ); Child Sleep Habits Questionnaire (CSHQ), which may have compromised the assessment of prevalence [14][15][16][17][18][19][20][21][22] .…”

Section: Prevalence Etiology and Correlating Factors For Sleep Disord...mentioning

confidence: 99%

Sleep disorders in Down syndrome: a systematic review

Santos¹,

Costa²,

Linhares

et al. 2022

Arq. Neuro-Psiquiatr.

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Background: Sleep disorders are commonly observed in children with Down syndrome (DS) and can lead to significant behavioral and cognitive morbidities in these individuals. Objective: To perform a systematic review evaluating sleep disorders in individuals with DS. Methods: Search strategies were based on combinations of keywords: “Down syndrome”; “trisomy 21”; “sleep disorders”; “dyssomnias”; “sleep apnea”; “obstructive”; “sleeplessness”; “insomnia”; “parasomnias”; and “excessive daytime sleepiness”. PubMed and Science Direct were used. Only original studies and retrospective reviews in English published between January 2011 and March 2021 were included. Results: 52 articles were included, most of them involving children and adolescents under 18 years of age. The main sleep disorder associated with DS was obstructive sleep apnea (OSA). Some studies reported the presence of cognitive dysfunction in patients with DS and sleep-disordered breathing, and few have been found about parasomnia, insomnia, and daytime sleepiness in these patients. Movement disorders and unusual postures during sleep may be related to disordered sleep breathing in DS. The main treatment options for OSA are continuous positive airway pressure therapy (CPAP), surgery, and weight control. Computational modeling associated with MRI has been used to plan surgical interventions in these patients. Conclusions: Individuals with DS are at high risk of developing sleep-related breathing disorders. The main sleep disorder associated with DS was OSA. The presence of sleep-disordered breathing contributes to a worsening of cognitive function in patients with DS.

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The spectrum of obstructive sleep apnea in infants and children with Down Syndrome

Cited by 28 publications

References 31 publications

Central breathing abnormalities in children with trisomy 21: Effect of age, sex, and concomitant OSA

Central breathing abnormalities in children with trisomy 21: Effect of age, sex, and concomitant OSA

The impact of sleep problems on functional and cognitive outcomes in children with Down syndrome: a review of the literature

Sleep disorders in Down syndrome: a systematic review

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