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Screening for obstructive sleep apnoea (OSA), which is recognised to be present in 30%–60% of children with Down syndrome (DS) compared with 0.6%–2% of the general population, is controversial. Untreated, OSA can lead to complications such as pulmonary hypertension, behavioural problems and failure to thrive. However, the best screening tool remains debatable. Royal College of Paediatrics and Child Health (RCPCH) guidelines1 recommend screening children with DS with overnight oximetry and referring those with abnormal results for polysomnography. However, in our experience, oximetry remains insufficiently sensitive to detect the majority of cases.
We performed a three-stage study to determine the effectiveness of current diagnosis and screening for OSA in DS patients. A retrospective case review from 2007 to 2009 and …