Use of Sleep Evaluations and Treatments in Children with Down Syndrome

Esbensen, Anna J.; Beebe, Dean W.; Byars, Kelly C.; Hoffman, Emily K.

doi:10.1097/dbp.0000000000000333

Cited by 33 publications

(26 citation statements)

References 39 publications

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“…The most common treatment children in our study underwent was T&A, because adenotonsillar hypertrophy is a major contributor to SDB . It was undertaken in 37% of our cohort with OSA‐mixed SDB, a rate slightly lower than that reported in another study . Children who underwent T&A before first PSG were typically younger than those undergoing T&A after PSG.…”

Section: Discussionmentioning

confidence: 76%

“…Finally, treatment options for SDB have evolved over time with increasing use of cine‐MRI and newer surgical interventions such as lingual tonsillectomy . Nonetheless, the most common treatment options for SDB in children with Down syndrome remain adenotonsillectomy and PAP therapy …”

Section: Discussionmentioning

confidence: 99%

“…18,19 It was undertaken in 37% of our cohort with OSA-mixed SDB, a rate slightly lower than that reported in another study. 13 Children who underwent T&A before first PSG were typically younger than those undergoing T&A after PSG. This is likely because young children with classic signs and symptoms of OSA were referred directly for treatment, as is often the practice in our center given resource limitations in obtaining PSG.…”

Section: Interventions For Sdb On Initial and Subsequent Psgmentioning

confidence: 99%

“…Finally, treatment options for SDB have evolved over time with increasing use of cine-MRI22 and newer surgical interventions such as lingual tonsillectomy. 14 Nonetheless, the most common treatment options for SDB in children with Down syndrome remain adenotonsillectomy and PAP therapy 13. 5 | CONCLUSIONS/FUTURE DIRECTIONSOur study demonstrates that SDB persists or recurs in three of four children with Down syndrome with moderate-severe SDB on initial PSG and/or persistence/recurrence of symptoms.…”

mentioning

confidence: 92%

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Treatment and persistence/recurrence of sleep‐disordered breathing in children with Down syndrome

Nehme

LaBerge

Pothos

et al. 2019

Pediatric Pulmonology

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Objective Sleep‐disordered breathing (SDB) is common in children with Down syndrome, but the trajectory and long‐term outcomes are not well‐described. In a retrospective longitudinal cohort of children with Down syndrome, study objectives were to (1) characterize polysomnography (PSG), treatments received, and persistence/recurrence of SDB and (2) explore predictors of SDB persistence/recurrence. Methods A retrospective cohort study was conducted of children who underwent PSGs between 2004 and 2014. SDB was defined as obstructive sleep apnea (OSA)‐mixed (apnea‐hypopnea index [AHI] >5 events/hour), central sleep apnea or hypoventilation. PSGs, interventions, and trajectory of SDB were described. Age, body mass index (BMI) Z‐score and AHI at first SDB diagnosis were evaluated as predictors of persistent/recurrent SDB. Results Of 506 children, 120 had ≥1 PSG; 54 had subsequent PSGs. Children with ≥2 PSGs were more likely to have higher total AHI (P = .02) and obstructive‐mixed AHI (P = .01). Thirty‐five of fifty‐four (65%) were initially diagnosed with OSA‐mixed SDB. After first PSG, 67 of 120 had OSA‐mixed SDB, of whom 25 (37.3%) underwent adenotonsillectomy (T&A), 13 (19.4%) received positive airway pressure (PAP). Those who underwent T&A after PSG were significantly younger than those who received PAP (median age 6.2 vs 12.5 years; P = .005). OSA‐mixed SDB persisted/recurred in 33 of 54 (73.3%) with ≥2 PSGs. Persistence/recurrence was not associated with age, AHI or BMI Z‐score at first SDB. Conclusion Children with Down syndrome undergoing T&A for SDB were significantly younger than those treated with PAP. SDB persisted/recurred in three of four and was not predicted by age, SDB severity or BMI Z‐score. Longitudinal PSG assessment for persistence/recurrence of SDB is required in this population.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Interventions For Sdb On Initial and Subsequent Psgmentioning

confidence: 99%

mentioning

confidence: 92%

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Treatment and persistence/recurrence of sleep‐disordered breathing in children with Down syndrome

Nehme

LaBerge

Pothos

et al. 2019

Pediatric Pulmonology

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“…17 The 2011 "Health Supervision for Children with Down Syndrome" clinical report by Bull and the American Academy of Paediatrics Committee on Genetics recommends discussing the symptoms of sleep difficulties with parents and that all children must undergo an overnight diagnostic polysomnography by 4 years of age. 18 Pharmacological treatments for OSA have limited safety and efficacy data for children with DS. Adenotonsillectomy can produce significant benefit for younger children with OSA, but nocturnal hypoxia can persist despite surgery in many cases or it can return in later childhood.…”

Section: Discussionmentioning

confidence: 99%

Otorhinolaryngological manifestations in Down syndrome: MERF experience

Anto¹,

Natarajan²,

Sampathkumar³

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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Background: Syndromic children often pose a spectrum of challenges to the paediatric otolaryngologist. Syndromes like the Down syndrome present with a multitude of manifestations in the head and neck region and require careful management.Methods: A retrospective study of thirty patients with Down syndrome presenting from January 2013 to January 2018 in a tertiary care setting was done. All patients were evaluated by ENT examination and further investigations based on the complaints. The aim was to study the various ENT disorders in Down syndrome patients and their management. Results: The most common disorder was hearing loss in eleven patients followed by rhinosinusitis in ten patients, adenoid hypertrophy and otitis media with effusion (OME) in six patients and obstructive sleep apnea in three patients. Most of the patients had medical management; very few needed surgery. Successful outcomes were possible for all patients.Conclusions: Dealing with otorhinolaryngological disorders may pose a management challenge in Down syndrome and this requires a well experienced ENT, medical and rehabilitative team to provide optimal management and good quality of life to these children.

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Sleep‐related disorders in children: A narrative review

Cohen,

Reiter,

Gileles‐Hillel

2024

Pediatric Discovery

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Sleep‐related disorders in children can significantly impact children's physical, emotional, and cognitive development and constitute a major source of parental concern. This comprehensive review aims to describe sleep‐related disorders commonly encountered in pediatric practice, their etiology, diagnosis, and management strategies. The review explores various disorders prevalent in different age groups, including insomnia, sleep apnea, parasomnias, and circadian rhythm disorders, highlighting the importance of early identification and intervention for optimal child health and well‐being.

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Use of Sleep Evaluations and Treatments in Children with Down Syndrome

Cited by 33 publications

References 39 publications

Treatment and persistence/recurrence of sleep‐disordered breathing in children with Down syndrome

Treatment and persistence/recurrence of sleep‐disordered breathing in children with Down syndrome

Otorhinolaryngological manifestations in Down syndrome: MERF experience

Sleep‐related disorders in children: A narrative review

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