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Abstract Introduction Down Syndrome (DS) is the most common chromosomal disorder, occurring in 1 in every 700 births. Clinically reported symptoms of obstructive sleep apnea (OSA), such as snoring, have been shown to be unreliable for predicting the presence of OSA in the DS population. With the prevalence of OSA in this vulnerable population estimated between 50-79%, and the lack of guidance that the traditional symptoms provide in clinical decision making, the American Academy of Pediatrics (AAP) recommends all children with DS be screened for OSA with polysomnography (PSG) before their 4th birthday. Previous studies conducted shortly after the publishing of these guidelines showed suboptimal adherence. Both DS and OSA impact medical costs over time, with OSA leading to a doubling of medical expenses (cite) and DS increasing it twelve-fold. Early diagnosis and treatment of OSA in children with Down Syndrome is imperative to improving morbidity in this patient population and lowering overall healthcare cost and utilization. Methods In this retrospective chart review, an electronic medical record (EMR) query for all patients aged 3-8 years, with a diagnosis of DS, and who live in Illinois was performed. The query included if any sleep clinic or PSG orders were placed and when these orders were completed. The query yielded a convenience sample of 582 children. Results Only 26% (117) of the subjects had a sleep medicine clinic or PSG order in their chart with 21% (124) having completed a PSG, and 11% (62) completed a sleep medicine visit. Only 23% (111) of patients between 4-8 years old were compliant with AAP sleep testing guidelines. Conclusion There is opportunity to strengthen the process of screening DS patients for OSA. The low adherence to AAP guidelines shown in this, and previous studies, highlight the need for dedicated quality assurance and improvement programs aimed at closing this practice gap, especially within institutions who care for sizable Down Syndrome populations. Support (if any) none
Balog et al. (Sat,) studied this question.