title: Obstructive sleep apnea in young infants with Down syndrome evaluated in a Down syndrome specialty clinic.
abstract: Children with Down syndrome (DS) experience congenital and functional medical issues that predispose them to obstructive sleep apnea (OSA). Research utilizing stringent age criteria among samples of infants with DS and OSA is limited. This study examines clinical correlates of OSA among infants with DS. A retrospective chart review was conducted of infants ≤6 months of age referred to a DS clinic at a tertiary children's hospital over five-years (n = 177). Chi-square tests and binary logistic regression models were utilized to analyze the data. Fifty-nine infants underwent polysomnography, based on clinical concerns. Of these, 95% (56/59) had studies consistent with OSA. Among infants with OSA, 71% were identified as having severe OSA (40/56). The minimum overall prevalence of OSA among the larger group of infants was 31% (56/177). Significant relationships were found between OSA and dysphagia, congenital heart disease (CHD), prematurity, gastroesophageal reflux disease (GERD), and other functional and anatomic gastrointestinal (GI) conditions. Results indicate that odds of OSA in this group are higher among infants with GI conditions in comparison to those without. Co-occurring dysphagia and CHD predicted the occurrence of OSA in 36% of cases with an overall predictive accuracy rate of 71%. Obstructive sleep apnea is relatively common in young infants with DS and often severe. Medical factors including GI conditions, dysphagia and CHD may help to identify infants who are at greater risk and may warrant evaluation. Further studies are needed to assess the impact of OSA in infants with DS.
authors.affiliation: Leadership Education in Neurodevelopmental Disorders Program, Riley Hospital for Children, Indianapolis, Indiana.
authors.forename: Alida
authors.initials: A
authors.lastname: Goffinski
authors.forename: Maria A
authors.initials: MA
authors.lastname: Stanley
authors.forename: Nicole
authors.initials: N
authors.lastname: Shepherd
authors.forename: Nichole
authors.initials: N
authors.lastname: Duvall
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Jenkinson
authors.forename: Charlene
authors.initials: C
authors.lastname: Davis
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: Bull
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Roper
mesh_terms: D004314:Down Syndrome / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010641:Phenotype; D017286:Polysomnography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*
keywords: Down syndrome; apnea-hypopnea index; dysphagia; obstructive sleep apnea; polysomnography; sleep disordered breathing