Obstructive Sleep Apnea in Down Syndrome

Sleep apnea in Down Syndrome is a condition that needs to be taken seriously and addressed by a physician.

Obstructive Sleep Apnea occurs in over 50% of people with Down Syndrome. It has been recommended by U.S. researchers that all children with Down Syndrome be tested by the time they are between three and four years of age.(Shott, et al. 2006)

Many children with Down Syndrome have some type of heart condition. Since Obstructive Sleep Apnea (OSA) causes oxygen levels in the blood to be decreased, the occurence of sleep apnea in Down Syndrome could cause serious complications related to the child's heart condition.

Obstructive Sleep Apnea in Down Syndrome
can be caused by a number of factors:

• low tone
• the flat facial profile and typical facial structure often seen in people with Down Syndrome
• enlarged tonsils and/or adenoids
• allergies and stuffy noses
• the small mouth and seemingly large tongue

The symptoms of OSA vary but here are listed some of the common ones:

• Snoring or noisy breathing ( okay, that's the obvious one)
• strange sleeping positions (for example, with the head bent back at the neck)
• restless sleep, frequent waking at night
• mouth breathing
• behavioral problems
• weight loss or not gaining weight at the expected rate

How is Obstructive Sleep Apnea diagnosed?

Your ear, nose and throat doctor will likely recommend a test called a polysomnography. A polysomnography is usually done on an overnight basis. Your child will be carefully monitored while he or she sleeps.

Treatments for OSA include: removal of the tonsils and/or adenoids getting allergies under control the use of CPAP In his article about OSA in children with Down Syndrome Dr. Len Leshin,MD,FAAP recommends that the removal of tonsils and adenoids should not be day surgery. The child with Down Syndrome will usually have a longer recovery period and he or she will also have longer periods of decreased oxygenation. Therefore this child should be watched for a bit longer than a child who does not have Down Syndrome.

Personally Speaking: Sam does not snore. No really, he doesn't. He does however sleep in the strangest positions. Usually with his head bent back. He is also a very restless sleeper, constantly on the move in his crib (which is why he still sleeps in his crib). He can often be heard kicking the bars of the crib, or even the wall sometimes. He also does a lot of mouth breathing. Behavioral problems? Well, not him, but some of his brothers and sisters...Hmmm, I wonder if they snore?!

We will be making a visit to a sleep lab sometime before this year is over!

Sources for this article:

AAFP.org
kidshealth.org
LucilePackardChildrensHospital.org
ds-health.com

References: Shott S, Amin R, Chini B, Heubi C, Hotze S, Akers R (2006). "Obstructive sleep apnea: Should all children with Down syndrome be tested?". Arch Otolaryngol Head Neck Surg 132 (4): 432-6. PMID 16618913.

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