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Prevalence and predictors of obstructive sleep apnoea in young children with Down syndrome

Prevalence and predictors of obstructive sleep apnoea in young children with Down syndrome
Prevalence and predictors of obstructive sleep apnoea in young children with Down syndrome

Background

Children with Down syndrome (DS) are vulnerable to obstructive sleep apnoea (OSA) because of their unique craniofacial anatomy and hypotonia. Understanding the predictors of OSA in DS may enable targeted screening.

Methods

Children with DS (n = 202) aged from six months to below six years (110 boys) were recruited from three UK children's hospitals. The clinical assessment included height, weight and tonsillar size. The parents either set up cardiorespiratory polygraphy at home or chose laboratory studies. Studies with less than four hours of interpretable data were repeated where possible. American Academy of Sleep Medicine (AASM) 2012 scoring criteria were used to derive an obstructive apnoea/hypopnoea index (OAHI). Predictors of moderate to severe OSA were examined.ResultsIn total, 188/202 (93%) participants were successfully studied. Of these, 169 studies were completed at home and 19 in a sleep laboratory. Moderate to severe OSA, defined by an OAHI of >5/h, was found in 14% and mild to moderate OSA (1/h≥OAHI <5/h) was found in 59% of the children. Male gender and habitual snoring predicted OSA but did not have independent predictive power in the presence of the other factors. Age in months, body mass index (BMI) centile and tonsillar size did not predict OSA.

Conclusions

Moderate to severe OSA is common in very young children with DS. Examination of tonsillar size did not predict OSA severity. Population-based screening for OSA is recommended in these children, and domiciliary cardiorespiratory polygraphy is an acceptable screening approach. Further research is required to understand the natural history, associated morbidity, optimal screening methodology and treatment modality for OSA in these children.

1389-9457
99-106
Hill, Catherine
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Evans, Hazel J.
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Elphick, Heather
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Farquhar, Michael
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Pickering, Ruth
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Kingshott, Ruth
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Martin, Jane
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Reynolds, Janine
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Joyce, Anna
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Rush, Carla
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Gavlak, Johanna C.
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Gringas, Paul
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Hill, Catherine
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Evans, Hazel J.
b852cf27-9c11-403b-8e70-c54967c5c089
Elphick, Heather
b52520b9-6580-4ef9-8038-2d8a07baae9a
Farquhar, Michael
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Pickering, Ruth
4a828314-7ddf-4f96-abed-3407017d4c90
Kingshott, Ruth
d832ca93-ead4-40f4-bfe6-eef0a5580208
Martin, Jane
bb7a5243-8778-43fa-94fb-ea22a363211b
Reynolds, Janine
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Joyce, Anna
d1a82273-7d20-4c88-bb27-671c75652f85
Rush, Carla
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Gavlak, Johanna C.
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Gringas, Paul
200ecc1f-0790-45c7-944f-aacc0c07e107

Hill, Catherine, Evans, Hazel J., Elphick, Heather, Farquhar, Michael, Pickering, Ruth, Kingshott, Ruth, Martin, Jane, Reynolds, Janine, Joyce, Anna, Rush, Carla, Gavlak, Johanna C. and Gringas, Paul (2016) Prevalence and predictors of obstructive sleep apnoea in young children with Down syndrome. Sleep Medicine, 27-28, 99-106. (doi:10.1016/j.sleep.2016.10.001).

Record type: Article

Abstract

Background

Children with Down syndrome (DS) are vulnerable to obstructive sleep apnoea (OSA) because of their unique craniofacial anatomy and hypotonia. Understanding the predictors of OSA in DS may enable targeted screening.

Methods

Children with DS (n = 202) aged from six months to below six years (110 boys) were recruited from three UK children's hospitals. The clinical assessment included height, weight and tonsillar size. The parents either set up cardiorespiratory polygraphy at home or chose laboratory studies. Studies with less than four hours of interpretable data were repeated where possible. American Academy of Sleep Medicine (AASM) 2012 scoring criteria were used to derive an obstructive apnoea/hypopnoea index (OAHI). Predictors of moderate to severe OSA were examined.ResultsIn total, 188/202 (93%) participants were successfully studied. Of these, 169 studies were completed at home and 19 in a sleep laboratory. Moderate to severe OSA, defined by an OAHI of >5/h, was found in 14% and mild to moderate OSA (1/h≥OAHI <5/h) was found in 59% of the children. Male gender and habitual snoring predicted OSA but did not have independent predictive power in the presence of the other factors. Age in months, body mass index (BMI) centile and tonsillar size did not predict OSA.

Conclusions

Moderate to severe OSA is common in very young children with DS. Examination of tonsillar size did not predict OSA severity. Population-based screening for OSA is recommended in these children, and domiciliary cardiorespiratory polygraphy is an acceptable screening approach. Further research is required to understand the natural history, associated morbidity, optimal screening methodology and treatment modality for OSA in these children.

Text
Hill et al Down syndrome clean copy - Accepted Manuscript
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More information

Accepted/In Press date: 8 October 2016
e-pub ahead of print date: 22 October 2016
Published date: November 2016
Organisations: Primary Care & Population Sciences, Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 406414
URI: https://eprints.soton.ac.uk/id/eprint/406414
ISSN: 1389-9457
PURE UUID: 57b2976f-e05d-4613-a24b-01e7589f4e2f
ORCID for Catherine Hill: ORCID iD orcid.org/0000-0003-2372-5904

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Date deposited: 10 Mar 2017 10:46
Last modified: 20 Jul 2019 05:22

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