Obstructive sleep apnea in children with Down syndrome: is it possible to predict severe apnea?

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Hizal M., ŞATIRER Ö., Polat S. E., Tural D. A., Ozsezen B., SUNMAN B., ...More

EUROPEAN JOURNAL OF PEDIATRICS, vol.181, no.2, pp.735-743, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 181 Issue: 2
  • Publication Date: 2022
  • Doi Number: 10.1007/s00431-021-04267-w
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.735-743
  • Keywords: Down syndrome, Obstructive sleep apnea, Polysomnography, Sleep-disordered breathing, Central sleep apnea, PREVALENCE
  • Hacettepe University Affiliated: Yes


The objectives are to explore the demographic and polysomnographic features of children with Down syndrome and to determine the predictive factors associated with severe sleep apnea. A total of 81 children with Down syndrome referred for full-night polysomnography were analyzed. In addition, parental interviews were performed for each child. Data were available for 81 children, with a mean age of 4.8 years. Severe obstructive sleep apnea was determined in 53.1%. Age, sex, exposure to second-hand smoke, clinical findings, anthropometric features, and the presence of comorbidities were not predictors of severe obstructive sleep apnea. Children who were exposed to second-hand smoke had more sleep-related symptoms. Even in children without symptoms, the prevalence of severe obstructive sleep apnea was 40%. Moreover, 86% of parents had no previous information regarding possible sleep breathing disorders in their children. Clinically significant central apnea was present in 10 patients (12.3%). Conclusion: Our results demonstrate that severe obstructive sleep apnea is common in children with Down syndrome, even in children without a history of symptoms of sleep apnea. It is not possible to predict patients with severe apnea; thus, screening of children with Down syndrome beginning from young ages is very important. Central apneas could be a part of the spectrum of sleep abnormalities in Down syndrome.