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Down Syndrome Children Sleep Apnea
97% of children with down syndrome have sleep apnea:
Diagnostic overnight polysomnograms of 33 children with Down syndrome who snored were reviewed. Mean age was 4.9 years, none had had adenotonsillectomy, 91% were non-obese (Down syndrome specific body mass index standard deviation score (BMI SDS) <+2.0) and yet 97% demonstrated obstructive sleep apnoea, with an average apnoea hypopnoea index (AHI) of 12.9 episodes per hour (normal <1) and an average oxygen desaturation of 4%. A higher AHI was associated with lower minimum Spo2, higher Tcco2 and higher number of arousals from sleep per hour (p<0.001). Polysomnography should be a routine investigation for children with Down syndrome who snore regardless of body habitus. (excerpted from http://www.ncbi.nlm.nih.gov/pubmed/17449523)
Diagnostic overnight polysomnograms of 33 children with Down syndrome who snored were reviewed. Mean age was 4.9 years, none had had adenotonsillectomy, 91% were non-obese (Down syndrome specific body mass index standard deviation score (BMI SDS) <+2.0) and yet 97% demonstrated obstructive sleep apnoea, with an average apnoea hypopnoea index (AHI) of 12.9 episodes per hour (normal <1) and an average oxygen desaturation of 4%. A higher AHI was associated with lower minimum Spo2, higher Tcco2 and higher number of arousals from sleep per hour (p<0.001). Polysomnography should be a routine investigation for children with Down syndrome who snore regardless of body habitus. (excerpted from http://www.ncbi.nlm.nih.gov/pubmed/17449523)
Views: 467
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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Mike, I am very interested in this topic. I, not to long ago, had my first Downs case. I also have a friend from college with a downs child. He is a wonderful kid. I have found that as these children grow older sleep becomes thier enemy. Myoclonis jerks, night terrors, exploding head, and apnea are things that people with this challenge might have to face along with severe apnea. I have found that it has a little to do with the shape of thier face and the structuring of thier airway. This almost always makes mask selection a problem. Being that these people/children can grow to be very stubborn individuals, with OCD tendencies I would highly suggest getting them diagnosed and used to PAP treatment as early as possible. If anyone has any more info on this subject please let me know. If I had my way this is where I would focus all of my attention.
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Permalink Reply by Mike on
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97% is a staggering figure. my jaw just dropped when i read that, especially given that 91% were not obese. I have someone in my family who has Downs. I'll bring this to their attention.
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Permalink Reply by Pam on
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I find it interesting that it is recommened to get these childern with Down syndrome on CPAP at an early age. I whole heartedly agree, and I wish the FDA would see it this way. Recently insurance companies quit paying for the rental of CPAP machines in younger children because it has not been approved, nor is it recommended.
My three year old son has Down syndrome and has been on CPAP since he was 1 yr and a half due to his obstructive sleep apnea. We recently had to come up with the funds to purchase his machine since our insurance company would not pay for it anymore. The results of our son not being on CPAP are catastrophic. His apnea was so bad that it caused the right side of his heart to enlarge and his pulmonary pressures to sky rocket. Had he not been able to go on CPAP at the time our only other alternetive would have been a Tracheostomy.
http://www.theflockofbirds.blogspot.com
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i hadn't heard that the FDA had disapproved of CPAP in young children. really? any color on what their reasoning was?
Pam said:I find it interesting that it is recommened to get these childern with Down syndrome on CPAP at an early age. I whole heartedly agree, and I wish the FDA would see it this way. Recently insurance companies quit paying for the rental of CPAP machines in younger children because it has not been approved, nor is it recommended.
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I had not heard that either. That is crazy! I would think that they would wnt to get them on it as soon as possible. I have had older downs pts who have just down right said "NO" to the treatment. The apnea had already reached havic on thier bodies. If they had only been put on the therapy sooner a lot of thier health problems might have been avoided.
Pam said:I find it interesting that it is recommened to get these childern with Down syndrome on CPAP at an early age. I whole heartedly agree, and I wish the FDA would see it this way. Recently insurance companies quit paying for the rental of CPAP machines in younger children because it has not been approved, nor is it recommended.
My three year old son has Down syndrome and has been on CPAP since he was 1 yr and a half due to his obstructive sleep apnea. We recently had to come up with the funds to purchase his machine since our insurance company would not pay for it anymore. The results of our son not being on CPAP are catastrophic. His apnea was so bad that it caused the right side of his heart to enlarge and his pulmonary pressures to sky rocket. Had he not been able to go on CPAP at the time our only other alternetive would have been a Tracheostomy.
http://www.theflockofbirds.blogspot.com
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Permalink Reply by Steven Y. Park, MD on
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The results of this study are not too surprising. Downs kids have underdevelopment of their facial bones. They also typically have large tongues (which may be relative, since they have small jaws). Just goes to show that it's your anatomy that predisposes you to sleep apnea. Obesity is the end result.
If I remember correctly, most people with Downs die of heart disease in their middle years.
Interestingly Dr. Eric Maier published a series on using Coblation energy to vaporize and debulk tongue tissues in children with macroglossia, with good results (called the SMILE procedure). Basically you're doing a submucosal partial glossectomy, without cutting the mucous membranes. I've started doing this in adults for sleep apnea on a very limited basis, with good results subjectively overall, but we'll have to wait on objective test results.
There are also ways of enlarging upper and lower jaws in young children, especially if you're predisposed to sleep apnea.
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hey, not to get into politics, but say what you will about Sarah Palin, she's a prominent spokesperson for Downs kids. Would be cool to get this on her radar, and boost awareness of Sleep Apnea all in one shot.
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Pam, if you have any literature on the FDA ruling I would really like to see it. I have searched, but have not been able to find anything. This subject has sort of become my sleep sub plot.
Pam said:I find it interesting that it is recommened to get these childern with Down syndrome on CPAP at an early age. I whole heartedly agree, and I wish the FDA would see it this way. Recently insurance companies quit paying for the rental of CPAP machines in younger children because it has not been approved, nor is it recommended.
My three year old son has Down syndrome and has been on CPAP since he was 1 yr and a half due to his obstructive sleep apnea. We recently had to come up with the funds to purchase his machine since our insurance company would not pay for it anymore. The results of our son not being on CPAP are catastrophic. His apnea was so bad that it caused the right side of his heart to enlarge and his pulmonary pressures to sky rocket. Had he not been able to go on CPAP at the time our only other alternetive would have been a Tracheostomy.
http://www.theflockofbirds.blogspot.com
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Permalink Reply by sleepycarol on
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For you techs out there -- our hospital recently opened a new stand alone sleep clinic (it is located on the hospital property and is just across the street from the main hospital) and is really advertising that they have set up a "special room" just for kids.
How many others have a "kid's room"?
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