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Mark Eric Dyken, MD; Deborah C. Lin-Dyken, MD; Susan Poulton, MSN, ARNP; M. Bridget Zimmerman, PhD; Erin Sedars, BS

Arch Pediatr Adolesc Med. 2003;157:655-660.

Objectives  To investigate obstructive sleep apnea (OSA) in a consecutively encountered, nonselected population of young patients with Down syndrome using standard overnight polysomnography and to determine the effects of therapy.

Methods  In a population of patients seen for routine developmental evaluations, 9 boys and 10 girls were studied using standard overnight polysomnography.

Results  Using pediatric standards, OSA was found in 79% of the subjects (95% confidence interval, 54%-94%), with a median apnea index of 3 events per hour (interquartile range, 2-5), a median apnea-hypopnea index of 6 events per hour (interquartile range, 3-8), and a median arterial oxygen saturation (SaO₂) low point of 88% (interquartile range, 84%-90%). Higher body mass index was significantly associated with a higher apnea index and a lower SaO₂ level, and there was a significant inverse relationship between age and the lowest SaO₂ value as well as a possible association between sleep-related symptoms at the time of diagnosis and the lowest SaO₂ value. In addition, patients with OSA had a significantly higher movement arousal index than those without OSA.

Conclusions  Using rigid polysomnographic standards, this pilot study revealed OSA in a high percentage of young subjects with Down syndrome and an association between OSA and obesity, age, and poor sleep quality. These findings justify larger and more detailed population studies to further define clinical factors that are concomitant with OSA in Down syndrome and to improve therapy.

From the Roy J. and Lucille A. Carver College of Medicine, Department of Neurology Sleep Disorders Center (Dr M. Dyken), the Department of Pediatrics, Division of Developmental Disabilities (Dr D. Lin-Dyken), and the College of Public Health, Departments of Epidemiology (Ms Sedars) and Biostatistics (Dr Zimmerman), University of Iowa; and the Grant Wood Area Education Agency (Ms Poulton), Iowa City, Iowa. The authors have no relevant financial interest in this article.

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