Prevalence of Obstructive Sleep Apnea in Children with Down Syndrome

To evaluate the prevalence of obstructive sleep apnea (OSA) in a large cohort of children with Down syndrome (DS), and to investigate which patient- related factors correlate with disease severity. We performed a retrospective, cross-sectional study in children with DS referred for full overnight polysomnography in a tertiary care center. Polysomnographic data are available for 122 children (70 boys), age 5.0 y (2.8–10.5), and body mass index (BMI) z-score 0.7 (−0.3 to 1.7). The overall prevalence of OSA was 66.4%. In almost half of these children severe OSA was diagnosed (obstructive AHI [oAHI] ≥ 10/h). In children with parental reports of snoring or witnessed apneas (group A), OSA was significantly more common (75.7%) than in those without these symptoms (group B) 53.8% (P = 0.019). Children in group A had more severe OSA, oAHI 5.7/h (1.7–13.8) compared to those in group B 2.2/h (0.8–8.0) (P = 0.018). A significant inverse correlation between age and oAHI (P = 0.028) was found. Sex and BMI z-score were not significantly correlated to oAHI. Based upon full night polysomnography, an overall 66.4% prevalence of OSA was found in children with Down syndrome. Even in those with a negative history for OSA, the prevalence was 53.8%. Younger age was associated with more severe disease. More than half of the children with Down syndrome have obstructive sleep apnea, documented by full night polysomnography. This high prevalence was found across all age groups between 0–18 years. It is strongly recommended to perform polysomnography to exclude obstructive sleep apnea in children with Down syndrome, irrespective of age or parental reports of snoring and witnessed apneas.