Sleep related upper airway obstruction in a cohort with Down's syndrome.

V A Stebbens, J Dennis, M P Samuels, C B Croft, D P Southall

National Heart and Lung Institute, Royal Brompton Hospital, London.

The prevalence of sleep related upper airway obstruction (UAO) was studied in a cohort of 34 children with Down's syndrome from a geographically defined area. Thirty two (94%) of the children, ranging in age between 0.1 and 4.9 years (median 1.4), underwent full clinical assessment for UAO including parental questionnaires and overnight tape recordings of chest wall movements and arterial oxygen saturation (SaO2). Compared with controls, children with Down's syndrome had (a) an increased incidence of stridor and chest wall recession during sleep, (b) an increased frequency of a pattern on inspiration indicating increased upper airway resistance, (c) a reduced baseline oxygen saturation (having excluded recordings on four children with potential for right to left intracardiac shunting), and (d) an increased number of episodes with SaO2 less than or equal to 90% despite continued chest wall movements. At their initial assessment seven children (22%) had evidence of UAO. The 18 youngest children (less than or equal to 1.7 years) underwent repeated recordings and clinical assessment until they had all reached 2 years of age. A further three were found to have developed UAO. Sleep related UAO is a common problem in children with Down's syndrome, occurring in 10 of 32 (31%) of this population based sample.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Shott, S. R., 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: 432-436 [Abstract] [Full Text]  
• Donnelly, L. F. (2005). Obstructive Sleep Apnea in Pediatric Patients: Evaluation with Cine MR Sleep Studies. Radiology 236: 768-778 [Abstract] [Full Text]  
• Donnelly, L. F., Shott, S. R., LaRose, C. R., Chini, B. A., Amin, R. S. (2004). Causes of Persistent Obstructive Sleep Apnea Despite Previous Tonsillectomy and Adenoidectomy in Children with Down Syndrome as Depicted on Static and Dynamic Cine MRI. Am. J. Roentgenol. 183: 175-181 [Abstract] [Full Text]  
• Turk, J (2003). Melatonin supplementation for severe and intractable sleep disturbance in young people with genetically determined developmental disabilities: short review and commentary. J. Med. Genet. 40: 793-796 [Abstract] [Full Text]  
• Dyken, M. E., Lin-Dyken, D. C., Poulton, S., Zimmerman, M. B., Sedars, E. (2003). Prospective Polysomnographic Analysis of Obstructive Sleep Apnea in Down Syndrome. Arch Pediatr Adolesc Med 157: 655-660 [Abstract] [Full Text]  
• Styles, M E, Cole, T J, Dennis, J, Preece, M A (2002). New cross sectional stature, weight, and head circumference references for Down's syndrome in the UK and Republic of Ireland. Arch. Dis. Child. 87: 104-108 [Abstract] [Full Text]  
• UONG, E. C., MCDONOUGH, J. M., TAYAG-KIER, C. E., ZHAO, H., HASELGROVE, J., MAHBOUBI, S., SCHWAB, R. J., PACK, A. I., ARENS, R. (2001). Magnetic Resonance Imaging of the Upper Airway in Children with Down Syndrome. Am. J. Respir. Crit. Care Med. 163: 731-736 [Abstract] [Full Text]