Obstructive sleep disorders in Down syndrome’s children with and without lower airway anomalies

Abstract

<b>Background:</b> Obstructive sleep disorders are an important health problem in Down syndrome (DS) children. Recent papers also show a relatively high proportion of DS children with lower airway anomalies. Data concerning the impact of lower airway anomalies on OSA (obstructive sleep apnea) are lacking. <b>Aim:</b> To compare the prevalence and severity of OSA in DS children with and without lower airway anomalies. <b>Methods:</b> We retrospectively compared polysomnography (PSG) and airway endoscopy data in a cohort of DS children. <b>Results:</b> PSG results were available for 115 DS patients. An airway anomaly was diagnosed in 34/115 children (29.6%). Most commonly, laryngomalacia, tracheomalacia or a combined airway malformation was found. In the remaining 81, endoscopy was normal or not performed because of low clinical suspicion. In both groups, the majority of patients was male (p=0.66). Distribution of BMI z-scores was similar. No differences were found concerning total sleep time and sleep efficiency. Both groups had a high prevalence of OSA (defined as an oAHI or obstructive apnea hypopnea index ≥ 2/hour): 87.9% in the group with an airway anomaly versus 89.9% without (p=0.75). Overall mean oAHI was 12.1/hour. Children with an airway anomaly were significantly younger at time of OSA diagnosis (4.3 versus 6.2 years, p=0.02). We found no difference in OSA severity (in terms of oAHI, mean and minimum saturation during PSG or oxygen desaturation index) nor in treatment regimen (conservative, local or CPAP treatment). <b>Conclusions:</b> Besides a younger age at time of OSA diagnosis, no differences in OSA severity or treatment policy were found between DS children with and without lower airway anomalies.